高血压患者合并阵发性房颤心脏超声指标的变化及其与房颤发生的关系

目的 研究高血压合并阵发性房颤患者左右心房内径、室间隔厚度、左心室内径和左室射血分数的变化及与高血压患者房颤发生的关系.方法 高血压合并阵发性房颤患者41例和单纯性高血压患者45例.经胸心脏超声测量两组患者收缩期左房前后径(Lad)和右房上下径(Rad)、舒张期左室内径(LVIDd)和室间隔厚度(IVSd)、左室射血分数(LVEF)与有无明显的二尖瓣返流(MR),所有房颤患者在窭性心律下做超声测量.结果 单纯性高血压患者相比,高血压合并阵发性房颤患者Lad(mm)和IVSd(mm)显著增大(Lad:36.1±5.8 vs 31.0±3.9,P<0.00l;IVSd:10.7±1.3 vs 9.9±1.5,P=0.001),MR发生率显著增高(52.5% vs 11.1%,P<0.001).两组Rad、LVIDd和LVEF差异均无显著性,其中两组Rad(mm)为46.4±7.1 vs 44.0±4.0(P=0.065).Logistic回归分析显示,Lad、IVSd和MR发生率均与高血压患者房颤发生有显著性关联OR(95% CI):Lad,1.375(1.135～1.665);IVSd,1.98(1.183～3.313);MR,4.708(1.126～19.685)].结论 高血压合并阵发性房颤患者较单纯性高血压患者左心房显著扩大、室间隔显著增厚和二尖瓣返流发生率显著增高,这三者是高血压患者发生房颤的预测因素.

Impact of atrial fibrillation on echocardiographic indices of hypertensive patients and their relationship with the development with atrial fibrillation.

Objective To investigate the differences of echocardiographic indices between the hypertensive patients with and without AF.Tb explore the relationship of these indices with the development of AF in hypertensive patients.Methods Totally 41 hypertensive patients with AF and 45 sex-,age-and risk faetors-matched hypertensive patients without AF were enrolled.The age for the two groups was 59.6±11.4 and 57.1±9.2 years old.respectively.All patients underwent transthoracie echocardiography assessment of left atrial anterior-posterior dimension(Lad),right atrial upper-inferior dimension(Rad),interventricle septum dimension(IVSd),left ventrieular diameter(LVIDd),left ventricular ejection fraction(LVEF)and qualitative assessment of mitrial regurgitation(MR).Results Hypertensive patients with AF had higher Lad and IVSd(1ad:36.1±5.8 vs 31.0±3.9mm,P<0.001;IVSd:10.7±1.3 vs 44.0±4.0mm,P=0.001),and higher MR incidence(52.5% vs 11.1%,P<0.001)compared with those without AF.No significant differences in Rad,LVIDd and LVEF were found between the two groups. By muhivariable analysis,Lad,IVSd and MR incidence were founded to be independent risk factor of AF development in hypertensive patients with the OR(95%CI)being 1.375(1.135～1.665),1.98(1.183～3.313)and4.708(1.126～19.685),respectively.Conclusion The combination of AF contributes to increase of Lad,IVSd and MR incidenee,each of which was associated with the development of AF in hypertensive patients.