| Objective Using the Cine Mr imaging of the heart (Cine-magnetic resonance imaging,Cine-MRI) assessment of left ventricular hypertrophy in patients with essential hypertension systolic diastolic function of left ventricular structure and its changes, aimed at awareness in patients with left ventricular hypertrophy on left ventricular hypertrophy and systolic diastolic function affection, the goal is to know the left ventricle plump diastolic function to the patient left ventricle structure and shade of contraction, hoping1) the heart movie MR technology can provides the objective basis for the clinical hypertension left ventricle plump patient heart shape, structure and functional evaluation.2) appraises the effect of left ventricle hypertrophy this independent factor that using heart movie MR the hypertension causes on the ventricular function, provides the reference for the clinical decision-making.Methods Collects in March,2012-April,2013Taiyuan central hospital involvement branch, heart internal illness branch and outpatient service and other diagnosis of the patients with elevated blood pressure, are divided into the hypertension not to merge (35cases) according to the patients with elevated blood pressure left ventricle room wall thickness plump, the hypertension merge plump (16cases) two groups; Moreover in Taiyuan central hospital Physical examination Center selection electrocardiogram, blood sugar and other index of correlation normal health control group30cases. All patients do not have other diabetes, coronary diseases, thyroid glands, nephrosis and systems and other serious disease; Non-magnetic resonance inspection contraindication.All patients do not have other diabetes, coronary diseases, thyroid glands, nephrosis and systems and other serious disease; Non-magnetic resonance inspection contraindication; All patients did not have claustrophobia and during the inspection not ill symptom. Uses1.5T magnetic resonance scanner Sonata and special-purpose heart of phased array coil Siemens Corporation, carries on the ventricular minor axes, the arrowy positions, two cavity positions, three cavity positions and four cavity position scanning to the object of study with ophthalmological and breath gate controlling technology and true FISP sequence. Has been covered bottom of the heart to the ventricular minor axis position movie image of heart point to use to carry on the room of wall locomotion evaluations. Application Siemens dedicated heart features measurement software (Argus) for heart features measurement, semi-automatic depicting left ventricular both within and outside the film outlines, will by contains of blood pool area added up (contains nipple muscle), uses Argus software automatically measurement out left room diastolic end volume (EDV), and left room shrink late volume (ESV), and peak shot blood rate (PER), and peak shot blood time (TPER), and peak filling time (TPFP), and peak filling rate (PFR), and Left ventricular mass (LVM) and the rate of left ventricular wall thickening (TN), cardiac function data are repeated each measurement2, and taking the average measured values, and draw the corresponding time-volume curve, and a time-change rate of left ventricular volume curve.Results1. Proportionality test:Essential hypertension group, essential hypertension following left ventricular hypertrophy group, normal control group and interclass compared with male to female ratio, average age, body mass index (body mass index, BMI), blood pressure and blood lipids constitute a match, there was no significant difference (p>0.05).Group group comparison of blood pressure and left ventricular hypertrophy of hypertension, the results are not significantly different (p>0.05).2.Cardiac function compared1)Cardiac diastolic function:Comparison of left ventricular diastolic function among the three groups:PFR value decrease of the hypertensive group compared with healthy group, TPFR extended, and statistically significant (P<0.05). Left ventricular hypertrophy groups relatively healthier group of PFR value decreases, TPFR extended, and statistically significant (P<0.01). PFR value group of hypertensive left ventricular hypertrophy groups reduced TPFR extended, and statistically significant (P<0.01).2) Cardiac systolic function, table2 shows that (1) EF:higher EF values change in hypertensive group compared with the control group, EF a statistically significant difference (P<0.05), left ventricular hypertrophy groups higher EF values compared with healthy controls, EF a statistically significant difference (P<0.01). Increase in left ventricular hypertrophy groups higher EF values blood pressure group, a statistically significant difference (P<0.05).(2) PER, and TPER:hypertension group more health against group of PER value reduces, TPER value extended, and differences has statistics meaning (P<0.01); left ventricular hypertrophy group and health against group comparison PER value reduces, TPER value extended, and differences has statistics meaning (P<0.01); left ventricular hypertrophy group and hypertension group comparison TPER value extended, and differences has statistics meaning (P<0.01).3)Left ventricular room wall increased thick rate:S1(basal)-S6(apex):hypertensive group compared with healthy controls each layer modulus of ventricular wall thickening are reduced, and the difference was statistically significant (P<0.05), and left ventricular hypertrophy in hypertensive group compared with healthy controls each layer modulus of the ventricular wall thickening are decreased, and the difference was statistically significant (P<0.01). Group of hypertensive left ventricular hypertrophy and hypertension compared diminishing value rate of ventricular wall thickening, a statistically significant difference (P<0.05).3.Myocardial mass LV mass index (LVMI):hypertensive group compared with healthy control group increased left ventricular mass index value, and the difference is statistically significant (P<0.01). Left ventricular hypertrophy in hypertensive group compared with healthy control group LVMI value increases, and the difference statistically significant (P<0.01). LVMI group of hypertensive left ventricular hypertrophy of hypertension group values increase, the difference statistically significant (P<0.01).Conclusion Heart magnetic resonance can accurate of measurement hypertension disease left ventricular hypertrophy of patients of left ventricular of structure, and features, its measurement of heart features parameter can for clinical provides diagnosis and treatment of basis; Description left ventricular hypertrophy is effect diastolic features reduce of independent of dangerous factor and forecast factor;Reducing left ventricular diastolic function in patients with hypertension, while systolic function under compensatory mechanisms as a whole are still maintained in the normal range, but partially impaired heart function, shows abnormal diastolic function is earlier than systolic function disabled exception; the heart111m magnetic resonance imaging can detect high blood pressure, systolic function of left ventricular hypertrophy in patients with essential hypertension in the compensatory phase. |
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