Left ventricular function in patients with grade 1 primary hypertension complicated with overweight and obesity was evaluated by echocardiography
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摘要:
目的 应用超声心动图评估1级原发性高血压合并超重肥胖患者的左室功能。 方法 选取我院确诊为1级原发性高血压患者60例作为病例组，其中体质量指数正常组（病例A组）35例、合并超重肥胖组（病例B组）25例。另选取60例健康体检者作为对照组。比较3组一般临床资料、常规超声参数（室间隔厚度、左室后壁厚度、左室射血分数、左室心肌功能Tei指数）、左室整体长轴应变以及心肌做功参数（整体做功指数、整体做功效率、整体有用功、整体无用功）的差异。 结果 3组组间比较室间隔厚度、左室后壁厚度、左室射血分数差异均无统计学意义（P > 0.05）。与对照组相比，病例A组及病例B组Tei指数增高，左室整体长轴应变减低（P < 0.05），病例组组间差异无统计学意义（P > 0.05）。与对照组比较，病例A组心率及心肌做功参数整体做功指数、整体有用功、整体无用功、整体做功效率差异无统计学意义（P > 0.05），病例B组心率及整体无用功增高，整体做功效率减低（P < 0.05），整体做功指数、整体有用功差异无统计学意义（P > 0.05）。 结论 1级原发性高血压合并超重肥胖患者左室整体功能及左室纵向应变减低，且左室心肌整体无用功增加，心肌做功效率减低。超声心动图技术多种参数联合运用能够更加客观、全面评价1级原发性高血压合并超重肥胖患者的左室功能情况。 Abstract:Objective To assess left ventricular function in patients with grade 1 essential hypertension combined with overweight and obesity through echocardiographic techniques. Methods Sixty patients diagnosed with grade 1 essential hypertension in our hospital were classified as the case group, including 35 hypertensives in the group with normal BMI (case A group) and 25 hypertensives in the group with combined overweight and obesity (case B group). Fifty healthy people were selected as the control group. The conventional ultrasound indices: interventricular septal thickness, left ventricular posterior wall thickness, left ventricular ejection fraction, left ventricular myocardial function Tei index, overall left ventricular global longitudinal strain, and myocardial work done indices, including global work index, global constructive work, global wasted work and global work efficiency were compared among the three groups. Results There were no significant differences in interventricular septal thickness, left ventricular posterior wall thickness and left ventricular ejection fraction among three groups (P > 0.05). Compared with the control group, the Tei index increased and global longitudinal strain decreased (P < 0.05), and there was no significant difference in the case groups (P > 0.05). Compared with the control group, there were no significant differences in the heart rate and myocardial work parameters global work index, global constructive work, global wasted work and global work efficiency in case group A (P > 0.05). The heart rate and global wasted work of case B increased, while the global work efficiency decreased (P < 0.05), and no statistical differences were found in global work index and global constructive work (P > 0.05). Conclusion In patients with grade 1 essential hypertension combined with overweight and obese patients, the global left ventricular function and global longitudinal strain was decreased, global wasted work was increased, and global work efficiency was reduced. The combined application of multiple parameters of echocardiography can more objectively and comprehensively evaluate left ventricular function in patients with grade 1 essential hypertension complicated with overweight and obesity. -
图 1 对照组及病例组左室压力曲线及心肌做功参数值
Figure 1. Left ventricular pressure curve and myocardial work parameter values in the control and case groups. A: Left ventricular pressure curve and myocardial work parameter values in the control group; B: Left ventricular pressure curve and myocardial work parameter values in case A group; C: Left ventricular pressure curve and myocardial work parameter values in case B group.
表 1 患者一般资料比较
Table 1. Comparison of general clinical data of patients (Mean±SD)
Group Age (years) BMI(kg/m2) Systolic pressure(mmHg) Diastolic pressure(mmHg) Heart rate(times/min) Control group 52±8.5 22.8±2.0 119.3±10.4 78.5.4±5.2 72.1±7.6 Case A group 52±8.8 23.9±1.8 149.6±5.9a 92.4±5.5a 74.6±8.5 Case B group 53±8.6 27.6±2.5ab 151.6±6.1a 93.2±6.4a 88.6±6.4ab aP < 0.05 vs control group; bP < 0.05 vs case A group. Case A group: group with normal BMI; Case B group: group with combined overweight and obesity. 
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表 2 常规超声测量值比较
Table 2. Comparison of conventional ultrasonic measurements (Mean±SD)
Group IVS (mm) LVPW (mm) LVEF（%） Tei Gontrol group 9.63±0.47 9.22±0.26 63.00±4.10 0.38±0.07 Case A group 10.48±0.39 9.46±0.35 64.00±3.60 0.55±0.08a Case B group 10.87±0.55 10.12±0.77 68.00±5.50 0.57±0.05a aP < 0.05 vs control group. IVS: Interventricular septal thickness; LVPW: Left ventricular posterior wall thickness; LVEF: Left ventricular ejection fraction.
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表 3 左室整体长轴应变测值及心肌做功参数比较
Table 3. Comparison of overall left ventricular long axis strain measurements and myocardial work parameters
Group GWI(Mean±SD) GCW(Mean±SD) GWW GWE GLS(Mean±SD) Gontrol group 1870.80±288.70 2288.50±318.30 88.80(55.70-98.90) 96.00（95.00-97.00） -21.20±1.80 Case A group 1947.80±312.40 2301.70±270.20 92.50(50.20-102.80) 96.00（95.00-97.00） -17.80±1.60a Case B group 1954.80±303.40 2323.30±270.20 156.80(105.60-178.30)ab 93.00（91.00-95.00）ab -17.10±1.50a aP < 0.05 vs control group; bP < 0.05 vs case A group. GWI: Global work index; GCW: Global constructive work; GWW: Global wasted work; GWE: Global work efficiency; GLS: Global longitudinal strain.
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