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JAHA:中重度主动脉瓣狭窄的运动平板试验:与过度血压升高相关的左心室因素

2018-11-20 xiangting MedSci原创

在主动脉瓣狭窄患者中,过度的血压升高与较高的静息血压值、左心室质量和与高血压无关的动脉硬度增加密切相关。

运动期间的过度血压反应可以预测一般人群和不同患者群体未来的高血压和心血管事件。然而,其在主动脉瓣狭窄患者中的临床和预后意义尚未被评估。

这里回顾性研究了301名中至重度无症状主动脉瓣狭窄患者(年龄65±12岁),这些患者接受超声心动图和改良Bruce运动平板试验。过度的血压反应定义为峰值收缩压≥190mmHg。58%的患者血压反应异常(反应减弱或过度),82%的患者左心室几何结构异常。中度和重度主动脉瓣狭窄患者的异常血压反应率无差异([过度血压反应:21% vs 22%,P=0.876]和[血压反应减弱:35% vs 40%,P=0.647])。过度血压反应的患者(21%)更可能年龄较大、患高血压、试验前收缩压、左室射血分数和质量较高,以及动脉硬度增加(P均<0.05)。在多因素logistic回归分析中,过度血压反应与较高的脉压/每搏输出量指数(优势比2.45,95%置信区间1.02-6.00,P=0.037)和左心室质量相关(优势比2.04,95%置信区间1.23-3.38,P=0.012),并与年龄、高血压、主动脉瓣环和左心房直径以及左室射血分数无关。

在主动脉瓣狭窄患者中,过度的血压升高与较高的静息血压值、左心室质量和与高血压无关的动脉硬度增加密切相关。

原始出处:

Sahrai Saeed. Exercise Treadmill Testing in Moderate or Severe Aortic Stenosis: The Left Ventricular Correlates of an Exaggerated Blood Pressure Rise. JAHA. 17 November 2018.

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    2018-11-22 zhaohui6731
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    2018-11-20 ylzr123

    好文,值得点赞!认真学习,应用于实践!谢谢分享给广大同好!

    0

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