| Objective:Right ventricular function has become a predictor of the prognosis of cardiovascular diseases of different etiology,and right ventricular function is associated with adverse outcomes.At present,the research on the influence of hypertension on right ventricular changes is still poorly understood.Therefore,more experimental studies are needed to explore the effects of hypertension on the structural and functional changes of the right ventricle,and to grasp the laws of disease occurrence and development.This study mainly observes the changes in the structure and function of the right heart in patients with essential hypertension,and further studies their correlation in order to provide clinical evidence for preventing or slowing down the progression of the disease.Methods:This is a cross-sectional study.Selected 432 hypertensive patients living in the First Geriatric Department of Lanzhou University Hospital from May2019 to October 2022 were included in the EHT group according to the inclusion and exclusion criteria,a total of 193 hypertensive patients,(89 males,104 females),aged(63.09±12.11)years;One hundred and eight relatively healthy individuals(39 males,69 females),aged(62.1±11.72)years,admitted to the hospital during the same period,were selected as the control group.The baseline data,laboratory tests and their right heart structural and functional parameters were analyzed in both groups.Then,patients≥65 years old in the EHT group were defined as senile hypertension(SEHT)and included in the SEHT group,and controls≥65 years old were included in the senile control group(SCG),and the basic data,laboratory tests and right heart structural and functional parameters of both groups were analyzed.Further grouped according to BMI,BMI<18.5 was represented as low weight group(n=5);BMI 18.5-23.9 as normal weight group(n=67);BMI 24-27.9 as overweight group(n=101)and BMI≥28 as obese group(n=20).Baseline data,laboratory tests and right heart structural and functional parameters were analyzed for the four groups.Results:1.There were more women than men in the EHT group,and the incidence of atherosclerosis,lacunar cerebral infarction,and stroke were 48.2%,38.9%,and6.2%.RBC,HBG,red blood cell pressure,ALT,ALB,UA,Ca2+,CK,T3,T4 and BMI were higher in the EHT group,and the differences were obviously(P<0.05)The difference in statistics is significant(P<0.05).2.The right heart function parameters s’and A were greater in the EHT group than in the control group,and the differences were statistically significant(P<0.05).the patients in the EHT group had altered pulmonary circulation hemodynamics,and PASP,TRV,and TRpre Grad were greater than in the control group,and the difference in statistics is significant(P<0.05).The right heart structural parameters in the EHT group were:RV-FWs,RV-D1,RV-D2,RA-D1,RA-D2,RA-A,were greater than the control group,and IVC-CI-sf was smaller than the control group,with statistically significant differences(P<0.05);LVIDd,LVIDs,IVSTd,IVSTs,PWTs,LVM,LVMi,LAD,LADi,LAV,LAVi,LA-A1,LA-A2,E/e’s,M-E/e’were noticeably higher than people with normal blood pressure(P<0.05);e’s/a’s,a’s,e’L,e’_L/a’_L,in the EHT group were noticeably lower than the control group(P<0.05).3.Time of disease in the SEHT group was longer than that in the young and middle-aged group,and have significant differences in statistics(P<0.05);diastolic blood pressure,HBG,and TC were lower than those in the young and middle-aged group,and the differences in NT-pro BNP,D-dimer,and body surface area were higher than t the young patients(P<0.05);RV-D3,RA-D2,A,and DT in the SEHT group were greater than those in the young and middle-aged group,and IVC-CI-sf,RV-As,E/A,E’/A’,and E/Ea were lower than those in the young and middle-aged group,differences is significant in statistics(P<0.05);BMI,Ca2+,UA,BMI,and BMI were higher in the SEHT group than in the S-control group,and differences is significant in statistics;(P<0.05);right heart function parameters E/A were smaller in the SEHT group than in the control group,and A,ET-pulse were greater than the control group,and the differences were statistically significant(P<0.05).right heart structural parameters:RV-D1,RV-D2,RA-D1,RA-D2,RVOT1,AO,PA/AO,TRpre Grad were greater than the control group,and IVC-CI-sf were smaller than the control group in the SEHT group,and the differences were statistically meaningful(P<0.05).4.The differences in age,diastolic blood pressure and heart rate among the different body mass index groups in the EHT group were statistically significant(P<0.05);the age of the low body mass group was greater than that of the normal,overweight and obese groups;the diastolic blood pressure RBC,HBG and UA in the obese group were higher than those in the remaining three groups,and the differences in TC,Ca2+,LDL-C vitamin B12 were lower than the other groups were significan in statistic(P<0.05)The differences were statistically significant(P<0.05)between the groups of body mass index RV-D3,RA-D2,RVOT,IVCexp,IVCsniff,PA,PA/Ao,RV-Ad,RV-As,FAC,RV-Vol-d,RV-Vol-s,AO,PAP,and compared with the low weight and normal BMI groups,the obese group RV-D3,RA-D2,RV-Vol-s,AO,PAP,and RV-Vol-s were statistically significant(P<0.05).D3,RA-D2,RVOT,RV-Ad,RV-As,RV-Vd,RV-Vs,PA,AO,PA/Ao,PAP were higher than the other group,and FAC,IVCexp,IVCsniff were lower than the normal group(P<0.05).5.Analysis of correlation results:right ventricular wall thickness RV-D1,RV-D2,and RV-D3 in EHT patients were correlated with EP0,body surface area,BMI,LVMi-L,LVIDd,PWTs,LVMi-L,LAVi,LVEDVi,LVESV,LIVRT,E/A,DT,IVRT,E’s/A’s,E’s,M-E/E’were positively correlated(P<0.05);with PA,vitamin b12,NT-pro BNP,and LVEF were negatively correlated(P<0.05);right atrial wall thickness RA-D1,RA-D2,and right atrial area RA-A,diastolic blood pressure,EP0,body surface area,BMI,LVIDd,IVSTd,PWTs,LVMi-L,LAVi,LVEDVi,LVESV,LVESV,IVRT,E/A,E’s,E/E’s,AO were positively correlated(P<0.05);with vitamin b12 were negatively correlated(P<0.05);RVOT was positively correlated with body surface area,BMI,LVIDd,PWTs,LVMi-L,LAVi,LVEDVi,LVESV,IVRT,E’s/A’s,and M-E/E’were positively correlated(P<0.05).It was negatively correlated with TC,vitamin B12,TSH,and E’s(P<0.05).TAPSE was positively correlated with EPO,body surface area,LVIDd,PWTs,LVMi-L,LAVi,LVEDVi,LVESV,and E/A(P<0.05);RVEF was negatively correlated with and BMI,body surface area,and AO(P<0.05);s’was negatively correlated with heart rate(P<0.05);e’/a’was positively correlated with LAVi(P<0.05)and with vitamin b12(P<0.05).DT was positively correlated with LVEDVi,DT,E/A,IVRT have negative impact on DBP,heart rate,and AO(P<0.05);e’was positively correlated with systolic blood pressure,TG,EPO,and LAVi(P<0.05);and e/e’was positively correlated with body surface area(P<0.05).r V-Ad,r V-As were negatively correlated with UA,BMI,body surface area,and LVIDd,PWTs,LVMi-L,LAVi,LVEDVi,LVESV,DT,IVRT,E’s,E’s/A’s were positively correlated with UA,BMI,body surface area,LVIDd,PWTs,LVMi-L,AO(P<0.05);negative correlation with vitamin b12,LVEF(P<0.05);PA was positively correlated with TSH,BMI,body surface area,LVIDd,PWTs,LVMi-L,AO positively correlated with E/A,S’s,and PAP(P<0.05);PASP was positively correlated with vitamin b12,E’s,M-E/E’,and PAP(P<0.05);PVR have positively effected on PAP,LVEDVi,LVESV(P<0.05),and have negative effects on E’s/A’s,and LVEF(P<0.05).6.Using multiple linear regression analysis,the results showed that LVEDVi(β=0.281,P=0.017),left heart E/A ratio(β=0.336,P=0.002),LVEDVi,and left heart E/A ratio were the influencing factors of right heart diastolic function with 20.1%variation in right heart diastolic function.Conclusion:EHT patients had increased right ventricular and right atrial thickness,widened right ventricular outflow tract,increased pulmonary circulation resistance,and reduced systolic and diastolic function.BMI was correlated with right ventricular structure and function in EHT patients,and overweight and obese patients had more significant right atrial and right ventricular thickening and reduced right ventricular systolic function than patients with normal BMI.LVEDVi and the left heart E/A ratio are influential factors in the right heart E/A ratio. |
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