The Relationship Between Pulse Wave Velocity And Left Cardiac Structure In Hypertension Patients

Objective:To explore the relationship between arterial stiffness and cardiac structure in the patients with hypertension.Methods:90 essential hypertensive patients range 40～70 years,mean(59.36±7.60) years,were recruited in our study,two-dimensional echocardiography were employed to examine cardiac structure.90 patients were divided into three groups:group 1,essential hypertension(EH) patients with left atrial enlargmenand and left ventricular hypertroph; group 2,EH patients with left atrial enlargmenand,group 3,EH patients with normal cardiac structure.Automatic pulse wave velocity(PWV) measurement system were employed to examine brachial-ankle PWV.The baPWV was used as an index to show artery distensibility.The left atrium diameter and interventricular septal thickness were defined as the indices of cardiac structure.Ejection fraction(EF) and its slope were used to evaluate the cardiac systolic and diastolic functions respectively.The datas are analyzed by pearson correlation and multivariate stepwise regression to discuss the factors influencing brachial-ankle Pulse Wave Velocity.Results:There is no statistical significance in basic situations of patients among the three groups of hypertension such as age,gender,body mass index,etc.BaPWV is higher in the three groups than that in the normal adults(BaPWV＜1400cm/s).baPWV in hypertensives with left atrial enlargmenand and left ventricular hypertroph were significantly higher than that in left atrial enlargmenand group[(1915±261)cm/s vs(1668±200)cm/s,P＜0.05].baPWV in hypertensives with left atrial enlargmenand group were significantly higher than that in normal cardiac structure group[(1668±200)cm/s vs(1469±147)cm/s,P＜0.05].Simple relationship analysis demonstrated that,baPWV had close relationship with age,LAD,IVS.E/A have negative correlation with baPWV.Mutiple factors analysis revealed E/A和baPWV were the main factors to affect IVS in hypertensive patients(R2=0.424).Age and baPWV were the main factors to affect LAD(R2=0.425). Conclusion:Hypertension could induce damage of large artery distensibility. baPWV could sensitive reflect change of large artery distensibility,it could be used as an important no-invasive,simple,repetitive measurement index to evaluate large artery damage and prognostic risk of hypertensive patients.The decrease of arterial distensibility will lead to further elevation of SBP and PP,which in turn causes left ventricular hypertrophy and impaired systolic and diastolic function,and eventually,the remodeling of the cardiac structure.Age are the main factors influencing large artery stifness,which is increased by age.There is no relation between large artery stifness and blood fat in the study of hypertension patients.Elevated baPWV has a close relationship with left ventricular remodeling and decreased diastolic function in patients with essential hypertension.