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目的探讨桡动脉增益指数(radial augmentation index,AIr)与原发性高血压患者左室肥厚和心脏功能的关系。方法前瞻性选取2009年1月至3月在北京大学第三医院心内科住院的患原发性高血压、超声心动图测定的左室射血分数(left ventricular ejection fraction,LVEF)≥50%的患者共102例,分析心率为75次/min标准化的桡动脉增益指数(AIrP75)和超声心动图测量的心脏结构及功能指标的关系。结果 102例患者中男性占68.6%,平均年龄(65.0±9.6)岁。AIrP75与心肌收缩期运动速度峰值(peakmyocardial systolic velocity,Sm)呈负相关(r=-0.24,P=0.017),与左室心肌重量指数(left ventricular massindex,LVMI)呈正相关(r=0.22,P=0.027)。将AIrP75与患者的临床特征及生化指标代入多元线性回归方程,结果显示AIrP75仍与LVMI(β=0.354,s=0.164,sβ=0.214,95%CI 0.028～0.681,P=0.034)及Sm(β=-0.042,s=0.020,sβ=-0.209,95%CI-0.082～-0.002,P=0.040)独立相关。结论本研究结果显示脉搏波增益指数(AIrP75)与左室射血分数正常的原发性高血压患者左室肥厚和心肌收缩功能受损独立相关,提示动脉僵硬度增加可能是原发性高血压患者心脏结构和(或)功能受损的早期标志。
Objective To investigate the relationship between radial augmentation index (AIr) and left ventricular hypertrophy and cardiac function in patients with essential hypertension. Methods From January to March 2009, patients with essential hypertension who were hospitalized in Department of Cardiology, Peking University Third Hospital were prospectively selected and their left ventricular ejection fraction (LVEF) ≥50% A total of 102 patients were enrolled. The relationship between cardiac function and cardiac function measured by the standardized radial artery gain index (AIrP75) with heart rate 75 beats / min and echocardiography was analyzed. Results Among the 102 patients, 68.6% were male, with a mean age of (65.0 ± 9.6) years. AIrP75 was negatively correlated with peak myocardial myocardial systolic velocity (r = -0.24, P = 0.017) and positively correlated with left ventricular mass index (LVMI) (r = 0.22, P = 0.027). The clinical characteristics and biochemical indexes of AIrP75 and patients were substituted into multivariate linear regression equation. The results showed that AIrP75 was still significantly associated with LVMI (β = 0.354, s = 0.164, sβ = 0.214, 95% CI 0.028-0.681, = -0.042, s = 0.020, sβ = -0.209, 95% CI -0.082-0.002, P = 0.040). Conclusions The results of this study show that the pulse wave gain index (AIrP75) is independently associated with impaired left ventricular hypertrophy and myocardial contractile function in patients with normalized left ventricular ejection fraction, suggesting that increased arterial stiffness may be associated with essential hypertension Early signs of cardiac structure and / or impaired function in patients.