Effect Of Essential Hypertension On Right Ventricular Structions And Functions

Objective:1.To Explore the different left ventricular configuration in hypertension disease and prognosis of right ventricular structure and function change.2. Echocardiographic evaluation of hypertension left ventricular configuration result in different relationship between the structure and function.Research contents and methods:Hundred hospitial patients with essential hypertension were select According to the patients with different left ventricular configuration with Ganau classification points, four groups: normalleft ventriele(groupA,21cases), eoncentrie- remodeling(groupB,25cases), conee-ntrie hypertrophy(groupC,40eases) and eccentrie hypertrophy(groupD,14cases), Chooseing 40 cases with normal blood pressure of healthy people as control group.Measured artery blood pressure of all the volunteers under the state of 15 minutes calm.All the volunteers underwent echocardiography. Measures included:1. The end一diastolic diameters of left ventricle(LVDd), interventricular septum thiekness(IVSTd),left ventrieular Posterior wall thickness(LVPWTd),All continuou3~Heartbeat periodic average values of measured value, calculating left ventrieular mass(LVM), left ventricular massi ndex(LVMI), relative wallthickness(RWT).2. Three dimensional echocardiography probe placed in the apical, rebuilding three dimensional structure of right ventricular reconstruction,along the right ventricular endocardium point outline RVESV(right ventricular end systolic volume)and RVEDV(right ventricular end diastolic volume), and calculate the RVSV(right ventricular stroke volume), RVEF%(left ventricular ejection fraction).3. Pulsed wave Doppler measures of tricuspid inflow velocities,namely peak E(early diastolic),peak A(late diastolic) and E/A ratio was calculated.4. Tissue Doppler Imaging in three anterior tricuspid annulus and mitral valve tricuspid annular motion velocity after measuring systolic and peak earlydiastolicvelocity(Em)and peak late diastolic velocity motion(Am), isovolumic contraction time(ICT) and isovolumetric relaxation time(IRT), ejection time(ET),The Em/Am and the right ventricular myocardium performance index RV-Tei, left ventricular work index LV-Tei were calculated.Results:1. C group, D group and control group, and A group, and B group of RVEDV,and RVESV, and RVEF had significant differences(P<0.05); C group RVSV and control group, and A group compared no significant differences, D group and other each group RVSV had significant differences(P<0.05).2. Hypertension groups average E/A value of tricuspid annular were < 1, average peak E in hypertensive groups compared with control group were significantly reduced, A peak was significantly higher, hypertension groups of average A peak were higher than the normal control group.3. Tricuspid valve annulus at the side wall of the right ventricle in hypertension groups Em and Em/Am than in the control group were reduced(P<0.05), in the hypertensive groups in Group C Em and Em/Am the lowest value, groups C and D Am were higher than control group P<0.05).4. High blood pressure groups of RV- Tei were increased(P < 0.05), and relatively extend the IRT and ICT in the hypertensive groups(P <0.05),ejection time(ET) shortening(P<0.05). Right ventricular Tei index was well associated with IRT,ET(r=0.83-0.75, p <0.001), but there were no significant correlated between ICT(r=0.34, P>0.05). Tei index and(IRT ICT) were discovered good correlation(r=0.89,P<0.001).Righ ventricular Tei index andt left ventricular Tei index,there were Positively correlated between the two(r=0.69, P<0.001).Conclusion:1. When there was no change in the early hypertensive left ventricular configuration, barriers have appeared on right ventricular diastolic function,left ventricular configuration decided the degree of right ventricular diastolic dysfunction.2. Hypertension patients no matter with or without left ventricular configuration changes all can appear higher left entricular Tei index, dysfunction have appeared on left ventricular function, configuration of normal left ventricular hypertensionpatients Tei index than the right ventricular Tei index rise early, left ventricular dysfunction was occured first than right ventricular.3. Left ventricular function was impacted of right ventricular function, Left ventricular dysfunction was accompanied by right heart function disorders.4. Tissue doppler can earlier diagnose of high blood pressure caused by right heart structure and function obstacle than conventional doppler, General assessment of myocardial function is more accurate.