| Objective:In this study,grade 3 patients with essential hypertension and left ventricular hypertrophy(LVH)were observed.The purpose of study is to investigate the relationship between serum sulfatide levels and ECG QT dispersion in patients with different types of cardiac hypertrophy and characterize the relationship between serum sulfatide expression and cardiac hypertrophy and its diagnostic value for the severity of hypertension by combining with the concentration of serum NT-proBNP.Method:A total of 110 patients(62 males,48 females)with grade 3 essential hypertension and LVH were selected,who were hospitalized and diagnosed in our hospital.According to left ventricular mass index and relative wall thickness,the patients were further divided into 3 groups as following: concentric remodeling group(23 males,19 females),concentric hypertrophy group(20 males,16 females)and eccentric hypertrophy group(19 males,13 females).Meanwhile,a total of 108 healthy subjects(65 males,43 females)were selected as the control group.The blood pressure of all patients was measured at a different time in a quiet state 3 times.Patients with grade 3 hypertension were diagnosed according to the Chinese hypertension prevention and treatment guideline in 2005(systolic pressure ≥180 mmHg and/or diastolic pressure≥110 mmHg).The Devereux formula was used to calculate the left ventricular mass index in all patients with hypertensive LVH.About 5 mL fasting venous blood were collected from LVH patients and control subjects in the early morning for determination of serum NT-proBNP and sulfatide.General data such as electrocardiogram(ECG)and echocardiography were analyzed to further calculate the QT interval dispersion(QTcd)corrected by heart rate.The QTcd,left ventricular mass index,NT-proBNP,and sulfatide concentrations in hypertensive LVH and normal controls were observed.Correlation analysis and multi-factor stepwise regression analysis were used to investigate the correlation between QTcd,NT-pro BNP and sulfatide concentrations and left ventricular mass index indicators.Results:1.The QTcd of patients with hypertensive LVH was 48.3±12.3 mm,and the QTcd was 38.2±8.7 mm in concentric remodeling group,46.7±10.2 mm in concentric hypertrophy group and 52.3±12.6 mm in eccentric hypertrophy group,respectively,which was higher than that of normal control group 32.8 ±7.2 mm,the difference was statistically significant(P<0.05).2.The serum NT-proBNP concentration in hypertensive LVH patients was 225.9±32.1 pg/ml,and the serum NT-proBNP concentration was 87±12.7 pg/ml in the concentric remodeling group,138±17.1 pg/ml in the concentric hypertrophy group,and 368±42.2 pg/ml in the eccentric hypertrophy group,which is higher than the normal control group 65.1±11.3 pg/ml,the difference was statistically significant(P<0.05).3.The serum sulfatide concentration was 14.1±1.2 μmol/L in hypertensive LVH patients,which was 10.4±0.8 μmol/L in centripetal remodeling group,13.2±1.2 μmol/L in concentric hypertrophy group,and 16.4±1.5 μmol/L in eccentric hypertrophy group,wich is higher than the normal control group 6.1±0.6 μmol/L,the difference was statistically significant(P<0.05).4.There was a significant positive correlation between serum sulfatide and QTcd,and the correlation coefficient was 0.580.Serum sulfatide was also positively correlated with LVMI,IVST,LVEDd,LVPW,and NT-pro BNP.The correlation coefficients were 0.421,0.353,0.418,0.375,and 0.436,respectively.After correcting age,sex and other confounding factors,serum sulfatide was still positively correlated with QTcd,LVMI,IVST,LVEDd,LVPW,and NT-proBNP.Conclusion:1.The QTcd was significantly prolonged in each group of hypertensive LVH patients,especially significantly prolonged in the eccentric hypertrophy group,which was statistically significant compared with the normal population(P<0.05).2.The levels serum sulfatide and NT-proBNP levels were significantly elevated in each group of hypertensive LVH patients,especially significantly increased in the eccentric hypertrophy group,which was statistically significant compared with the normal population(P<0.05)3.The QTcd length,serum sulfatide and NT-proBNP levels in hypertensive LVH patients were positively correlated with the severity of left ventricular involvement in hypertension,and the difference in serum sulfatide was statistically significant(P<0.05).Serum sulfatide is expected to be as a new marker for evaluating the severity of hypertensive heart disease damage and the prognosis of hypertension.4.Serum sulfatide is expected to be a new marker for evaluating the severity and prognosis of patients with hypertensive left ventricular hypertrophy. |
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