The Study Of Coronary Flow Reserve In Patients With Metabolic Syndrome

Object This study analyze correlation between TEE and TTE to evaluate the coronary flow reserve and coronary sinus flow reserve (CSFR) in patients with Metabolic Syndrome (MS) and normal subjects ,to evaluate the relationship between the Metabolic Syndrome and coronary heart disease(CHD);Comparing correlation between TEE and TTE show TTE can practically and accurately assess CSFR,which can be place of CFR;Meanwhile ,TTE can provide clue that MS can be prevented in early stage, and can offer a kind of more simple as well as realistic echocardiography to pre-diagnose for the patients. Method 37 patients with MS were taken as the sample group, while 25 normal persons as the control group. Both of them were taken the TEE and TTE to separately evaluate CFR and CSFR . Mensurate the data of DPV,DMV,VTID separately during at rest and 4 minutes later after dipyridamole injection. At the same time, inspecting blood pressure,heart rate and the change of electrocardiogram. Taken the rate of the maximum of the coronary blood flow after dipyridamole mainline to the rest's DPV as the data of CFR or CSFR.Compared CFR of the MS group and the control group to evaluate the relationship between the MS patients and CHD. At the same time, having the relativity analysis of the corresponding index of the TEE and TTE to evaluate the feasibility and veracity of the method that using TTE to evaluate CFR.Meanwhile,having the multiple regression analysis of the corresponding index of dangerous factors and decline of CFR used by TEE in MS,in order to evaluate the relationship between the CFR and dangerous factors .analysis : Weight , waist circumference , blood pressure , lipid lipemia,fasting blood glucose ,uricemia were found to be dangerous factors associated with CFR(P<0 05～0 001). So, CFR in MS was declined ,which resulted from several dangerous factors. Result (1) Comparison of the baseline: there was no significant different in the sex,age,stature,heart rate,LVDD,LVSD,LVEF,LVFS between two groups, a significant increase of condition including triglycermia (TG ),high density lipid cholesterol (HDL-C),fasting blood glucose (FBG),low density lipid cholesterol (LDL-C),avoirdupois were observed from the MS group(P<0.01). (2)Comparison of parameters on CFR and CSFR in the MS group and control group by using TEE and TTE: comparison the MS group and control group, There was no significant different in DPV between two groups at rest(P>0.05). it inclined there was no significant different in DPV between two groups at rest,which can be contrasted ;after infusing dipyridamole ,the DPV in both groups were also significantly increased(P<0.001) ,it inclined coronary flow blood in both groups were also increased after infusing dipyridamole , coronary flow blood was incentived maxium of expansion by dipyridamole .However, the increasing degree was lower in the MS group (P<0.001). (3) Comparison of CFR in the MS group and control group by using TEE and TTE: Comparison the MS group and control group, CFRmax,CFRmean,CSFRmax,CSFRmean were also lower than in control group(P<0.001),it proved CFR in MS was declined. There was no significant different in blood pressure ,heart rate after infusing dipyridamole(P>0.05).(4 ) Having the relativity analysis of the corresponding index of the TEE and TTE : CFR determined from TEE was correlated closely with those from TTE measurements . (P<0.001;),so TTE was in placed of TEE. (5) Having the multiple regression analysis of the corresponding index of dangerous factors and decline of CFR used by TEE in MS : Weight , waist circumference , blood pressure , lipidlipemia,fasting blood glucose ,uricemia were found to be negative correlativity associated with CFR(P<0 05～0 001), it proved decline of CFR in MS was caused by these dangerous factors . Conclusion 1 CFR in MS was obviously declined.⑴MS and normal persons depended on oxygen in artery , which can supply energy at rest .(2) After infusing dipyridamole ,the DPV in both groups were also significantly increased ,it inclined coronary flow blood in both groups were also increased after infusing dipyridamole , coronary flow blood was incentived maxium of expansion by dipyridamole . (3) CFRmax,CFRmean were also lower than in control group(P<0.001), CFR in MS was declined, it proved that there was microcirculation disturbance and early chang of coronary blood flow in the MS group. 2 CFR determined from TEE correlated closely well with CSFR from TTE measurements. So,TTE is a feasible method and provide reliable data on CFR, so TTE was in placed of TEE. 3 Having the multiple regression analysis of dangerous factors and decline of CFR used by TEE in MS : Weight , waist circumference , blood pressure , lipidlipemia,fasting blood glucose ,uricemia were found to be negative correlativity associated with CFR ; moreover , blood pressure and waist circumference were also independent dangerous factors . So, it proved decline of CFR in MS was caused by these dangerous factors .