高血压英文ppt精品课件_7

Echocardiography Hypertensive Heart Disease Hypertensive Heart Disease n End Organ Damage as a consequence of systemic hypertension. n Chronic systemic pressure overload Hypertensive Heart Disease n Results in LVH to maintain normal wall stress n Initially impaired diastolic function n Normal systolic function Hypertensive Heart Disease Long standing hypertension n Results in systolic dysfunction n LV dilation Hypertensive Heart Disease Other Findings n Aortic root dilation n Aortic valve sclerosis Hypertensive Heart Disease n Mitral annular calcification n Left atrial enlargment n Atrial fibrillation Hypertensive Heart Disease 2- Dimension/ M-mode n Concentric LVH n Increased wall thickness ( 11 mm) n Non-dilated chamber n Increased LV mass Hypertensive Heart Disease Diastolic function Impaired Relaxation n Prolonged IVRT n Decreased E wave n Decreased early deceleration slope n Increased A wave Hypertensive Heart Disease Systolic Function n Preserved until late in the diseased. n Small hypertrophied ventricle mid cavity obliteration at the end of systole may be seen with an associated Doppler high-velocity signal. Hypertensive Heart Disease Systolic Function n Signal is briefer (cf HCM) n Level of obstruction is mid ventricle n Obstruction exacerbated by hypovolemia or increased contractility. Hypertensive Heart Disease Other Echocardiagraphic findings n Aortic root dilation n Tortuosity of the ascending aorta, arch and descending aorta Hypertensive Heart Disease n Increased irregular echogenicity of the aortic walls atherosclerosis n Aortic annulus is not dilated Hypertensive Heart Disease n Aortic valve leaflet shows calcification aortic regurgitation. n Mitral annular calcification mitral regurgitation. n LA dilation due to MR and the chronically elevated LV-EDP. Hypertensive Heart Disease Clinical Utility n LV mass strong predictor of clinical outcome. n LV mass more accurate way of assessing the severity of the hypertension. n LV mass efficacy of the medical therapy. Hypertensive Heart Disease Hypertensive Heart Disease Hypertensive Hear