高血压病患者左心室构型对心房纤颤的影响.docVIP

高血压病患者左心室构型对心房纤颤的影响 　　摘要：目的：探讨高血压病患者左心室构型与心房纤颤的影响。方法：选择原发性高血压患者3671例，按超声心动图Ganau分类方法再将高血压患者分为四组：左心室几何构型正常组（NG组，1468例），左心室向心性重构组（CR组，324例），左心室向心性肥厚组（CH组，792例），左心室离心性肥厚组（EH组，1087例）。结果：与NG比较，CR组、CH组和EH组的房颤发生率明显增加（P0.05）；与CR组比较，CH组和EH组的房颤发生率明显增高（P0.05）；EH组房颤发生率值比CH组明显提高（P0.05）。根据多因素Logistic回归分析，左心室构型中舒张末期左室内径（LVEDD）和房颤发生率的相关性最密切。结论：原发性高血压患者房颤发生率随左心室几何构型的进展逐渐延提高，在左心室肥厚患者增加最为明显，其中LVEDD和房颤的相关性最大。 　　关键词：高血压 心房颤动 左心室构型 　　Doi：10.3969/j.issn.1671-8801.2014.02.003 　　The effect of left ventricular geometric model to atrial fibrillation in patients with essential hypertension 　　Lin Jianzhen Lin Jinxiu Bai Ping et al. 　　Abstract：Objective：To investigate the effect of left ventricular（LV）geometric model To atrial fibrillation（AF）in patients with essential hypertension（EH）.Methods：3671 patients with EH were enrolled.According to Ganau categories，these patients were divided into four groups：normal LV geometric model（NG group，1468 cases），concentric remodeling（CR group，324 cases），concentric hypertrophy（CH group，792 cases）and eccentric hypertrophy（EH group，1087 cases）.Result：Compared with NG groups，the incidence of AF in other three groups were all higher.Compared with CR groups，the incidence of AF of CH group and EH group were both higher（P0.05）.There was significant difference between CH group and EH group（17.0% vs21.8% P0.05）.According to Logistic regression Multiple-factors analysis，The strongest correlation between AF and the component of LV geometric model is Left ventricular end diastolic diameter（LVEDD）.Conclusion：The incidence of AF in patients with EH is increased following the developing of LV geometric model.It is obviously longer in patients with LV hypertrophy，LVEDD is the strongest correlation sign between AF and LV geometric model. 　　Keywords：High blood pressure Atrial fibrillation The left ventricular configuration 　　【中图分类号】R4 【文献标识码】A 【文章编号】1671-8801（2014）02-0003-01 　　高血压已成为心房纤颤的主要病因，高血压病患者发生房颤的机制被认为是左室肥大造成左室舒张功能障碍，使心房扩大和纤维化，导致电重构，心房电-机械时间延长，除极离散增加，引发房颤，但高血压病患