Tei Index, Acoustic Quantification And Conventional Echocardiographic Parameters Comprehensive Evaluat Left Ventricular Function In Hypertension

objectiveThis study compared analysis the Tei index, acoustic quantification (AQ) and conventional echocardiographic parameters to comprehensive evaluate the changes of left ventricular function in patients with hypertension, and to find out the changes of Tei index in patients with hypertension.Materials and methods1 Research objectThere were 30 subjects(10 mals,20 females, mean ages(54.5±9.4)years)in normal controlled group. ALL of them were not have the history of hypertension, diabetes, coronary heart disease.Abnormal group included 45 patients,with essential hypertension.Both of our hospital patients and outpatients, in line with WHO diagnostic criteria for essential hypertension: the systolic blood pressure (systolic blood pressure, SBP)≥140mmHg and (or) diastolic blood pressure (diastolic blood pressure, DBP)≥90mmHg.According to the thickness of the wall,the abnormal group was divided into the left ventricular non-hypertrophy and left ventricular hypertrophy, echocardiographic measurement of wall one or more than the following conditions were diagnosed left ventricular hypertrophy, three were less than the following data were diagnosed Left ventricular non-hypertrophic, (1)left ventricular posterior wall (posterior wall thickness, PWT)≥12mm; (2) interventricular septum (interventricular septum, IVS)≥12mm; (3) left ventricular mass index (left ventricular mass index LVMI) male≥134g/m2 , women≥110g/m2. According to the criteria ,the Left ventricular non-hypertrophic group had 21 patients, 8 males and 13 females, mean age (54.2±8.1) years; left ventricular hypertrophy group had 24 patients, 12 males and 12 females, mean age( 55.8±9.4 )years.2 Research indicators2.1 Conventional echocardiographic parametersAccording to the examination methods of the conventional echocardiography,took left ventricular parasternal long axis view, applicated M-mode ultrasound and two-dimensional ultrasound technology to measure the subjects end-diastolic interventricular septum thickness (IVST), end-diastolic posterior wall thickness (PWT), left ventricular end-diastolic diameter (LVDd), left atrial end systolic diameter (left atrium, LA), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume(LVESV), ejection fraction(EF),Fraction Shortening(FS). According to Devereux formula to calculate left ventricular mass (LVM), LVM (g) = 0.8×1.04 [(LVD + IVST + PWT) - (LVD)] + 0.6, (left ventricular mass idex) LVMI = LVM / BSA. Took apical four chamber view, placed color flow Doppler sample volume in the mitral valve, measured mitral early diastolic and late diastolic velocity ratio VE / VA.2.2 left ventricular AQ parametersThen took apical four-chamber side eager,started the second harmonic imaging and the AQ system, adjusted the overall gain, time gain compensation (TGC) and lateral gain compensation (LGC) and other control keys, maked AQ curve and left ventricular endocardial close fit, to delimit the entire left ventricular cavity delineation of regions of interest to record left ventricular volume - time curves and the curves were measured: left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (EF), left ventricular rapid filling volume at the end (ERFV), left atrial contraction filling volume before (OAFV), peak emptying rate (PER), peak rapid filling rate (PRFR ), peak atrial filling rate (PAFR); and calculated①left ventricular rapid filling volume (RF = ERFV - LV ESV);②left atrial contraction filling volume (AF = LVEDV-OAFV)③left ventricular filling volume (TF = LVEDV -LVESV);④left ventricular rapid filling volume and left atrial contraction filling volume ratio (RF / AF);⑤left ventricular rapid filling fraction (RFF = RF / TF×100%);⑥left atrial systolic filling fraction (AFF = AF / TF×100%);⑦peak rapid filling rate and peak atrial filling rate ratio (PRFR / PAFR).2.3 left ventricular Tei indexIn the apical five-chamber eager face, placed the pulsed Doppler sample volume between the anterior mitral leaflet and left ventricular outflow to obtain the mitral flow spectrum and the left ventricular outflow tract spectrum at the same time, measured isovolumic relaxation time (IRT), isovolumetric contraction time (,ICT), left ventricular ejection time (ET), left ventricular Tei index = (ICT + IRT) / ET.3 Statistical AnalysisAll statistical analyses were performed with SPSS16.0 software,ALL measurement data were expressed as mean±standard deviation (x±s), when compared means among many grous we adopted One-Way ANOVA test with post hoc comparison. EF of the Conventional echocardiographic indices and EF of the AQ index we adopted non-paired T test.A value of P <0.05 was considered significant. The relationship between Tei index and the AQ index parameters was used correlation analysis. the effect factors of Tei index were used multiple stepwise regression analysis.Results1 The age and heart rate showed no significantly different Among the three groups,and DBP,LVM,LVMI,IVS,IVPW,LA showed significantly different Among the three groups(p<0.05),and they had the trend to be higher.2 The conventional indicators of left ventricular heart function showed EF,LVEDV,LVESV were no significantly different Among the three groups. Compared with normal control group, the VE / VA of decreased(p <0.05).3 AQ indicators of left ventricular heart function showed that as compared with the normal control group, RFF of the left ventricular hypertrophy group was lower (P <0.05), PAFR was higher (P <0.05), AFFof the left ventricular non-hypertrophy group and the left ventricular hypertrophy group was higher, RF / AF was lower (P <0.05) . LVEF and PER of the left ventricular non-hypertrophy group and the left ventricular hypertrophy group were no significant difference (P> 0.05), LVEDV, OAFV of the left ventricular hypertrophy group increased (P <0.05), LVESV of the left ventricular non-hypertrophy group and the left ventricular hypertrophy group increased (P <0.05).4 Tei index of left ventricular heart function showed that as compared with the normal control group, Tei index, IRT, ICT of the left ventricular non-hypertrophy group and the left ventricular hypertrophy group of the left ventricular hypertrophy group were significantly higher (P <0.05), , and Tei index,ICT of the left ventricular hypertrophy group were higher than the left ventricular non-hypertrophy group (P <0.05), this showed the trend to be significantly higher. ET of the left ventricular hypertrophy group was shorter than the normal control group,the difference was statistically significant (P <0.05)5 Tei index and PAFR of left ventricular AQ indicators (r = 0.239, p <0.05), LVEF (r = 0.376, p <0.05) had the Related trends. Multiple stepwise regression analysis showed that LVM and Tei index had independently associatation(p <0.01))ConclusionsVE / VA of The conventional indicators of left ventricular heart function can be sensitive to reflect reduction of left ventricular diastolic function in essential hypertension groups compared with the normal control group.As a new method evaluate diastolic dysfunction, AQ can be regarded as the supplement to the conventional echocardiography indicators, combining this two methods we can effectively improve the clinical diagnosis of left ventricular diastolic dysfunction.Tei index react the whole left ventricular systolic and diastolic functions in patients with hypertension, it damage prior to hypertensive patients'myocardium appear hypertrophy, and it is more prominent impaired when left ventricular hypertrophy.Compared with conventional echocardiography parameters and AQ indicators ,Tei index can effectively evaluate the overall cardiac function in patients with hypertension and can reflect the severity of the target organ cardiac This measurement method is simple and less demanding on the instrument,it is worthy widely generalization to application on measurement of clinical cardiac function.