Yoshitomi Y, Nishikimi T, Abe H, Nagata S, Kuramochi M, Matsuoka H, Omae T
Division of Hypertension, National Cardiovascular Center, Osaka, Japan.
Hypertens Res. 1997 Mar;20(1):23-8. doi: 10.1291/hypres.20.23.
The effects of antihypertensive treatment on regression of left ventricular hypertrophy and on left ventricular systolic and diastolic function were investigated echocardiographically in 13 untreated patients with mild hypertension (group I) and 16 untreated patients with moderate to severe hypertension (group II). The left ventricular mass index, left ventricular wall thickness, end-systolic left ventricular wall stress, and diastolic filling indexes before treatment were significantly higher in group II than in group I (p < 0.01). The blood pressure of both groups decreased significantly after antihypertensive treatment (mean duration of follow-up, 1.8 +/- 0.3 yr in group I and 2.0 +/- 0.4 yr in group II) (p < 0.01). The left ventricular mass index did not change in group I, whereas it decreased significantly in group II (p < 0.01). The relation between fractional shortening and end-systolic wall stress was similar in both groups before treatment and was unaltered by treatment in either group. After treatment, peak velocity in early diastole (E) significantly increased in both groups; however, peak velocity in late diastole (A) did not decrease in either group. The A/E ratio was significantly decreased in both groups and was significantly higher in group II than in group I (p < 0.01). In conclusion, the results suggest that intrinsic contractility may not be affected by left ventricular hypertrophy or regression of left ventricular hypertrophy. A/E ratio decreased after antihypertensive treatment in patients with mild hypertension mainly because of a decrease in blood pressure.
采用超声心动图研究了抗高血压治疗对13例未经治疗的轻度高血压患者（I组）和16例未经治疗的中度至重度高血压患者（II组）左心室肥厚消退以及左心室收缩和舒张功能的影响。治疗前，II组的左心室质量指数、左心室壁厚度、收缩末期左心室壁应力和舒张充盈指数显著高于I组（p<0.01）。抗高血压治疗后两组血压均显著下降（I组平均随访时间为1.8±0.3年，II组为2.0±0.4年）（p<0.01）。I组左心室质量指数未改变，而II组显著下降（p<0.01）。治疗前两组的缩短分数与收缩末期壁应力之间的关系相似，且两组治疗后均未改变。治疗后，两组舒张早期峰值速度（E）均显著增加；然而，两组舒张晚期峰值速度（A）均未降低。两组A/E比值均显著降低，且II组显著高于I组（p<0.01）。总之，结果表明内在收缩性可能不受左心室肥厚或左心室肥厚消退的影响。轻度高血压患者抗高血压治疗后A/E比值降低主要是由于血压下降。
