The Relationship Of Superoxide Dismutase And Malondialdehyde Levels With Left Ventricular Geometry In Patients With Essential Hypertension

Objective:Essential hypertension can increase cardiac afterload,damage cardiomyocytes,and ultimately lead to abnormal left ventricular geometry through the rise of blood pressure and oxidative stress.However,current studies on patients with essential hypertension mainly focus on the relationship between oxidative stress and left ventricular structure,and rarely involve discussions on the correlation between oxidative stress and left ventricular geometry.Therefore,this study firstly analyzed the distribution of left ventricular geometry in essential hypertension patients and the difference of left ventricular function among different groups.Then the correlation of superoxide dismutase(SOD)and malondialdehyde(MDA)with left ventricular geometry and left ventricular function was discussed.Methods:222 patients diagnosed with essential hypertension in First Hospital of Shanxi Medical University from June 2021 to May 2022 were selected in our study.The healthy control group was 25 cases.Based on Ganau classification essential hypertension patients were assigned into four groups: 125 patients with normal configuration were assigned to the normal geometry(NG)group,57 patients were assigned to the centripetal remodeling(CR)group,25 were assigned to the centripetal hypertrophy(EH)group,and 15 were assigned to the centripetal hypertrophy(CH)group.Gender,age,height,weight,smoking history,blood pressure,blood glucose,blood lipids,SOD,MDA and echocardiographic parameters of all subjects were collected.LSD-t test and Chi-square test were used to compare the left ventricular structure and function parameters,general clinical data,blood biochemical parameters,SOD,and MDA among the five groups.Pearson correlation analysis was used to explore the relationship between SOD and MDA with left ventricular structure and function.Multivariate Logistic regression was used to analyze the correlation between SOD and MDA and left ventricular geometry.Results:(1)In this study,222 patients with essential hypertension were included,including125 in NG group,57 in CR group,25 in EH group,and 15 in CH group.(2)SOD level of healthy control group was 110.66±18.49(U/ml),and the SOD level of essential hypertension patients was reduced.The SOD levels of NG group,CR group,EH group and CH group were 99.97±18.11(U/ml),88.96±17.01(U/ml),76.22±11.64(U/ml)and68.26±11.27(U/ml),respectively.(3)MDA level of healthy control group was 4.44±2.12(μmol/L),and that in essential hypertension group was increased.The MDA of NG group,CR group,EH group and CH group were 4.91±1.92(μmol/L),5.78±2.19(μmol/L),6.92±1.70(μmol/L)and 7.15±1.80(μmol/L),respectively.(4)LVEDD,IVSd,LVPWd,LVMI,RWT,LA,E,A,E/A,e’,e’,E ’/a’,a’,Tei index,LVEF,GLS,base segment longitudinal strain,middle segment longitudinal strain and apical segment longitudinal strain were significantly different among all groups(P<0.005).(5)Pearson correlation analysis indicated that SOD was negatively correlated with IVSd(r=-0.349,P<0.001),LVEDD(r=-0.188,P=0.005),LVPWd(r=-0.361,P< 0.001),GLS(r=-0.426,P<0.001),while positively correlated with LVEF(r=0.344,P< 0.001).MDA was positively correlated with IVSd(r=0.249,P<0.001),LVPWd(r=0.263,P< 0.001),a’(r=0.056,P=0.020),GLS(r=0.408,P< 0.001),while negatively correlated with LVEF(r=-0.398,P<0.001),e’(r=-0.144,P=0.032),e’/a’(r=-0.226,P=0.001).(6)Multivariate logistic regression analysis demonstated that SOD was associated with CR(β=-0.030,OR=0.970,P=0.003),EH(β=-0.129,OR=0.879,P<0.001)and CH(β=-0.228,OR=0.796,P<0.001).And MDA was associated with CR(β=0.186,OR=1.204,P=0.043),EH(β=0.787,OR=2.197,P=0.001)and CH(β=1.300,OR=3.669,P<0.001).Conclusions:SOD and MDA levels were correlated with left ventricular structure and function in essential hypertension patients.SOD and MDA may be important influencing factors of left ventricular geometry change.