CAJ | 학술논문

目的探讨高血压病的不同左室几何构型阶段左房壁的心肌运动与升主动脉的弹性功能之间的相关性.方法选取高血压患者294例,其中正常构型者87例(组Ⅱ),向心性重构者69例(组Ⅲ),向心性肥厚者57例(组Ⅴ),离心性肥厚者81例(组Ⅴ).另择同期正常体检人群45例(组Ⅰ).测定左心房的侧壁、房间隔、前壁、下壁、前间壁、后壁中点的组织速度显像(TVI)、组织追踪显像(TTI)、应变率显像(SRI)曲线,计算平均收缩期峰值速度(APVs),平均舒张早期速度(AVe),平均舒张晚期速度(AVa),平均收缩期峰值位移(APDs)、平均收缩期峰值应变率(APSRs),平均舒张早期应变率(AEsr),平均舒张晚期应变率(AAsr);同时测定升主动脉的僵硬指数(βao)、膨胀性(AD)、压力应变弹性系数(EPao)等.将左房壁各组织多普勒参数与主动脉各动脉僵硬度参数进行相关性分析.结果Ⅲ、Ⅳ、Ⅴ组的βao、EPao 分别与 APVs、Ave 明显相关(P<0.05),Ⅱ、Ⅲ、Ⅳ组的βao、EPao,Ⅲ组的 AD 与 AEsr 明显相关(P<0.05);Ⅱ~Ⅴ组 EPao、Ⅱ~Ⅳ组的βao 与 AASR 均明显相关(P<0.05);r 值最高(0.52)为Ⅲ组的 EPao 与 APVs(P<0.01),直线回归方程为:Y=57.82X-166.00.结论除左室正常构型阶段的收缩期外,高血压病的左室不同几何构阶段在不同时相,左房壁心肌运动与升主动脉的弹性功能之间存在一定的相关性.
목적탐토고혈압병적불동좌실궤하구형계단좌방벽적심기운동여승주동맥적탄성공능지간적상관성.방법선취고혈압환자294례,기중정상구형자87례(조Ⅱ),향심성중구자69례(조Ⅲ),향심성비후자57례(조Ⅴ),리심성비후자81례(조Ⅴ).령택동기정상체검인군45례(조Ⅰ).측정좌심방적측벽、방간격、전벽、하벽、전간벽、후벽중점적조직속도현상(TVI)、조직추종현상(TTI)、응변솔현상(SRI)곡선,계산평균수축기봉치속도(APVs),평균서장조기속도(AVe),평균서장만기속도(AVa),평균수축기봉치위이(APDs)、평균수축기봉치응변솔(APSRs),평균서장조기응변솔(AEsr),평균서장만기응변솔(AAsr);동시측정승주동맥적강경지수(βao)、팽창성(AD)、압력응변탄성계수(EPao)등.장좌방벽각조직다보륵삼수여주동맥각동맥강경도삼수진행상관성분석.결과Ⅲ、Ⅳ、Ⅴ조적βao、EPao 분별여 APVs、Ave 명현상관(P<0.05),Ⅱ、Ⅲ、Ⅳ조적βao、EPao,Ⅲ조적 AD 여 AEsr 명현상관(P<0.05);Ⅱ~Ⅴ조 EPao、Ⅱ~Ⅳ조적βao 여 AASR 균명현상관(P<0.05);r 치최고(0.52)위Ⅲ조적 EPao 여 APVs(P<0.01),직선회귀방정위:Y=57.82X-166.00.결론제좌실정상구형계단적수축기외,고혈압병적좌실불동궤하구계단재불동시상,좌방벽심기운동여승주동맥적탄성공능지간존재일정적상관성.
[ ] Objective To investigate the elastic functions of ascending aorta and myocardial motions of left atrial wal in different geometric configurations stage of left ventricular in essential hypertension (EH). Methods 294 cases patients with EH were selected.In the patients, there were 87 cases in the left ventricular normal geometry (groupⅡ) , 69 cases in the left ventricular concentric remodeling (group Ⅲ), 57 cases in the left ventricular concentric hypertrophy (groupⅣ) and 81 cases in the left ventric-ular eccentric hypertrophy (groupⅤ). In the same period , there were 45 cases in normal group (group Ⅰ) selected from crowds of physical examination. Al the patients with essential hypertension underwent color Doppler ultrasound examinations. The curves of tissue velocity imaging (TVI), tissue tracking imaging (TTI), strain rate imaging(SRI)were obtained in the midpoint of left atrial lat-eral wal , interatrial septum, anterior wal , inferior wal , anterior septum wal and posterior wal . The average peak systolic velocity (APVs), average early diastolic velocity (AVe), average atrial systolic velocity (AVa), average peak systolic displacement (APDs), average peak systolic strain rate (APSRs), average early diastolic strain rate (AEsr) and average atrial systolic strain rate (AAsr) were calculated. The aortic β stiffness index (βao), aortic distensibility (AD) and aortic pressure strain elastic modulus (EPao) were also calculated. The linear correlations were analyzed between every tissue Doppler parameters of left atrial wal and every stiffness parameters of aorta. Results There was linear correlation of βao and EPao with APVs and Ave, respectively in groupsⅢ, Ⅳ, Ⅴ. There was linear correlation of βao and EPao with AEsr in groups Ⅱ, Ⅲ, Ⅳ and linear correlation of AD with AEsr in group Ⅲ(P<0.05). There was linear correlation of βao with AAsr in groups Ⅱ, Ⅲ, Ⅳ and of EPao with AAsr in groups Ⅱ, Ⅲ, Ⅳ, Ⅴ(P<0.05). The r value (0.52) of EPao with APVs in group Ⅲ was the highest (P<0.01) and the regression equation was Y=57.82X -166.00. Conclusion Except systole of normal configuration stage of left ventricular, there were correlations of myocardial motion of left atrial wal and elastic function of ascending aorta with different left ventricular geometric configuration stage at different time phase.