고혈압성 망막증과 좌심실 비대의 상관관계

초록

Background: Left ventricular hypertrophy (LVH) and hypertensive retinopathy are outstanding manifestations of target organ damage in hypertensive patients. They are also cosidered as independent risk factor predicting mortality in patients with hypertension. Hypertensive retinopathy is easily diagnosed by simple ophthalmoscopic examination. For now, there have been many studies about relationship between LVH and cardiovascular disease. But few studies have define correlation between LVH and hypertensive retinopathy. The aim of this study is to define the correlation between LVH and hypertensive retinopathy and whether LVH can be predicted by ophthalmoscopic examination in patient with essential hypertension. Methods: We measured and calculated left ventricular mass index (LVMI) of first diagnosed hypertensive patients (male 7, female 15, mean age 54.2±9.7) by echocardiogram. Hypertensive retonopathy grades were checked by flat bed scanner and NIH image program. We measured diameters of retinal artery, retinal vein and artery/ vein (A/V) ratio by fundus photography. Hypertensive change and atherosclerotic change of retina were graded by Scheie classification from 0 to 4. Then we compaired and analyzed these data with left ventricular mass indices. Results 1. We could detect no valuable correlation between LVMI (176.3±97.0 gm/m2) and diameter of retinal artery (100±11.2 μm), retinal vein (134±16.6 μm), or A/V ratio (0.75±0.09). 2. There were positive correlation between LVMI and retinal grades of hypertension(H) and atherosclerosis(A) (H:r-0.65 p=0.006, Ar-0.53 p=0.037). Conclusion: Among the findings of hypertensive retinopathy, hypertensive and atherosclerotic changes of retinal vessels have positive correlation with LVMI. But diameters of retinal artery and vein, or A/V ratio have no meaning to estimate LVH. It suggests hypertensive retinopathy has meaningful correlation with LVH and ophthalmoscopic examination is simple and useful method predicting LVH.

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