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目的应用经胸多普勒超声心动图(TTDE)冠状动脉血流成像技术(coronary flow imaging,CFI),评估高血压患者冠脉微循环功能。方法 51例冠状动脉造影无冠状动脉明显狭窄,分为高血压组(25例)及正常对照组组(26例)。所有患者行TTDE-CFI检查,应用腺苷进行负荷超声心动图实验,得到静息及负荷状态下的冠状动脉平均峰值流速,并计算冠状动脉血流速度储备(CFVR)。结果高血压组及正常对照组间临床基线资料未见明显差异。高血压组患者血压相关参数高于正常对照组,差异有统计学意义。两组间冠状动脉血流相关参数在静息及负荷状态下未见显著性差异,但高血压组CFVR较正常对照组显著减低(2.44±O.49 vs 3.33±0.40,P<0.000 1)。结论 CFVR减低是评估高血压患者微血管功能受损有效、无创性方法。
Objective To evaluate coronary microcirculation function in hypertensive patients by transthoracic Doppler echocardiography (TTDE) coronary flow imaging (CFI). Methods 51 cases of coronary angiography without significant stenosis of coronary artery, divided into hypertension group (25 cases) and normal control group (26 cases). All patients underwent TTDE-CFI examination, and adenosine stress echocardiography was performed to obtain the mean peak coronary flow velocity under resting and loaded conditions and to calculate the coronary flow velocity reserve (CFVR). Results There was no significant difference in clinical baseline data between hypertensive group and normal control group. The blood pressure related parameters in hypertension group were higher than those in normal control group, the difference was statistically significant. There was no significant difference between the two groups in the parameters of coronary blood flow at rest and in load, but the CFVR in hypertensive group was significantly lower than that in the normal control group (2.44 ± 0.49 vs 3.33 ± 0.40, P <0.0001). Conclusions The reduction of CFVR is an effective and noninvasive method to evaluate the impaired microvascular function in hypertensive patients.