比较不同左心室几何形态的原发性高血压患者的心律失常。

Z Zheng, R Zhou, Q Liang
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摘要

研究了本质性高血压患者不同左心室几何形态心律失常的差异。179 名本质性高血压患者接受了 24 小时动态心电图记录、动态血压监测、超声心动图检查等。根据检查结果,确定了左心室几何形态和心律失常。比较左室重构组和正常几何形态组心律失常的发病率。通过多元逐步回归分析,确定了心律失常的独立决定因素。在对这些预测因素进行控制或调整后,比较了不同左室几何形态的心律失常严重程度。结果发现,左室重塑组的房性心律失常、室性心律失常和复杂室性心律失常的发病率分别明显高于正常几何形态组。影响原发性高血压心律失常的独立因素很多。其中,左心室解剖结构、高血压分级、左心房内径、E/A、夜间舒张压负荷值、日平均心率等指标非常重要。在对上述因素进行调整后,保留了部分几何图形间心律失常阶次的差异,这是由于几何图形的差异造成的。导致本质性高血压心律失常的因素很多,如高血压分级、LVMI、LA、脉搏波速度等。不同左心室几何形态的心律失常严重程度不同。
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Comparison of arrhythmias among different left ventricular geometric patterns in essential hypertension.

The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording, ambulatory blood pressure monitoring, echocardiography examination, etc. According to the examinations, left ventricular geometric patterns and arrhythmias were identified. The comparison of morbidity of arrhythmias between the left ventricular remodeling group and the normal geometric pattern group was performed. The multiple stepwise regression analysis was carried out to identify the independent determinants of arrhythmias. After these predictors were controlled or adjusted, the severity of arrhythmias among different left ventricular geometric patterns was compared. It was found that the morbidity of atrial arrhythmia, ventricular arrhythmia and complex ventricular arrhythmias in the left ventricular remodeling group was significantly higher than in the normal geometric pattern group respectively. There were many independent factors influencing on arrhythmias in essential hypertension. Of all these factors, some indices of left ventricular anatomic structure, grade of hypertension, left atrial inner dimension, E/A, diastolic blood pressure load value at night and day average heart rate and so on were very important. After the above-mentioned factors were adjusted, the differences of the orders of arrhythmias between partial geometric patterns were reserved, which resulted from the differences of the geometric patterns. Many factors contributed to arrhythmias of essential hypertension, such as grade of hypertension, LVMI, LA, PWT and so on. The severity of arrhythmias was different in different left ventricular geometric patterns.

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