| Objective This study was designed to evaluate the serum marker of procollagen and echocardiographic integrated backscatter (IBS) in the essential hypertensive patients with left ventricular hypertrophy, to assess relations between the serum markers and the parameters of echocardiography including of integrated backscatter and of left Ventricular diastolic function in essential hypertensive patients.Methods The study was performed in 94 essential hypertensive patients (41 patients with left ventricular hypertrophy and 53 patients without left ventricular hypertrophy ) and 32 normotensive control subjects. Left ventricular hypertrophy (LVH) criteria was derived left ventricular mass index(LVMI)≥ 135g/m~2 in men and ≥110g/m~2 in women by M-mode echocardiography. Two-dimensional, M-mode and Doppler ultrasound recordings were obtained in every subject to determine several parameters of the left ventricular anatomy and function. The detection content listed below.(1) The serum concentration of Carboxyterminal propeptide of type I procollagen (PICP), Serum procollagen type Ⅲ (PCⅢ), laminin (LN) and hyaluronic acid (HA) were measured by specificradioimmunoassay. 2) the LV internal diameter and wall thickness were measured by M-mode echocardiography.(3) Mitral flow spectra and pulmonary venous flow spectra were recorded by pulsed Doppler.the maximal early (E),late (A) diastolic filling velocities and the isovolumic relaxation time (IVRT) Were determined, and the E/A ratio was calculated.(4)The pulmonary venous flow wave parameters included the peak flow velocity during ventricular systole and diastolic (S and D), the peak of retrograde velocity at atrial contraction(AVP).(5)Myocardial ultrasonic backscatter parameters such as Average image intensity (All) and Peak to Peak intensity(PPI) were measured by AD technique. Intergroup differences were tested for significance by means of student's / tests.Results 1. Age and sex had no significant difference among three groups (P>0.05). The levels of blood pressure were higher in group of essential hypertension with left ventricular hypertrophy (EH-LVH) than that in the group of essential hypertension without left ventricular hypertrophy (EH-NLVH) and normotensive patients, (P<0.05) .2. PICP, PCIII, LN and HA concentrations were significantly increased(P<0.05) in group EH-LVH (134.77 + 41.54 ng/L, 124.76±27.81 g/L, 159.27±49.03 ug/L, 72.91+29.53 ug/L) and group EH-NLVH (110.34 + 25.08 ug/L, 103.80 +20.86ug/L, 141.87 ± 20.77ug/L, 57.20 ± 12.91ug/L ) compared with normotensive subjects (84.24 + 21.69 ug/L, 83.57+13.67 ug/L, 120.74 + 21.00 ug/L, 47.51 ± 14.81 ug/L) , and the serum concentrations were higher in the group EH-LVH than that in the group EH-NLVH (PO.05).3. Average image intensity of interventricular septal (AAI) and All of posterior wall were significantly increased (P<0.05) in group EH-LVH (30.43 + 4.63 dB, 23.25 + 2.83 dB) compared with group EH-NLVH (27.29 + 4.07 dB,21.69 + 3.19 dB) and normotensive subjects (25.07 + 4.26 dB, 19.69+ 2.24 dB), and thatwere higher in group EH-NLVH than that in normotensive subjects group (P<0.0\). Corrected Acoustic Intensity (CAI) of IVS and PW (All of IVS and PW were corrected by All of pericardium or ventricular chamber:CAI,,CAI2 CAI3,CAI4) were significantly increased (P<0.05) in group EH-LVH ( CAI, 0.81 ±0.15, CAI2 3.44 + 0.59, CAI3 0.62 + 0.10, CAI4 2.65 + 0.42) and group EH-NLVH (0.69 + 0.12, 3.02 + 0.45, 0.55 + 0.07, 2.40 + 0.36) compared with normotensive subjects (0.60 + 0.08, 2.53 + 0.43, 0.47 + 0.06, 2.02 + 0.46), and that were higher in group EH-LVH than group EH-NLVH (PO.05). PPI of IVS and PW weresignificantly decreased (PO.05) in group EH-LVH (7.42+ 1.39dB ,8.60+1.92 dB)and group EH-NLVH (8.16 + 1.98 dB, 9.49 + 2.05 dB) compared with normotensive subjects (9.05 + 1.22 dB, 10.91+2.07 dB ), and that were less in group EH-LVH than group EH-NLVH (PO.05) .4. The ratio of E/A and EVTI/AVTI (the ratio of flow velocity time integral of E and A) were significantly decreased (P<0.05) in group EH-LVH and group EH-NLVH compared with normotensive subjects .The pulmonary venous flow velocity variables including AVP, S/D and IVRT were significantly increased (PO.05) in group EH-LVH (AVP 33.65 ±3.73 cm/s ) and group EH-NLVH (30.74 + 4.05 cm/s) compared with normotensive subjects(25.63+ 3.90 cm/s ), and that higher in group EH- LVH than in group EH-NLVH (PO.05).5. All of IVS and PW(AAI,AII, ) were correlated positively with the serum concentrations of PICP and PCIII (AAI: r=0.565 and 0.349 ,AII, r=0.483 and 0.312), CAI,, CAI2 , CAI3 ,CAI4 were correlated positively with the serum concentrations of PICP and PCIII and LN.6. The serum concentrations of PICP were correlated positively with AVP, S/D, IVRT and LVMI(r=0.188, 0.451, 0.285 0.417). HA were correlated positively with...
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