The Research Of Cardiac Structure And Function By Echocardiography In A Chinese Population

Echocardiography is one of the most popular imageology technologies which are widely used in clinical medicine both domestically and abroad.It has its own advantages as non-invasion,fidelity,convenience and repeatability.Echocardiography can not only perform the measurement of cardiovascular anatomic structure,but also the evaluation of cardiac systolic and diastolic function.It perfectly combines the structural measurements and functional evaluations,so it offers the crucial evidence for the diagnosis of cardiovascular diseases. Along with the development of echocardiography,echocardiographic diagnostic methods and criterion becomes more and more normalized.All of these lead to the possibility of epidemical research based on echocardiography.The purpose of this study was to reveal the prevalence and determinants of left ventricular hypertrophy and diastolic dysfunction and to investigate the association of the metabolic syndrome(MS)and its components with cardiac structure and function in a Chinese population. The research included three parts:1.The research of prevalence and determinants of left ventricular hypertrophy. Objective:The objective of this study was to determine the prevalence and determinants of left ventricular hypertrophy(LVH)in a Chinese population.Methods:In 843 subjects recruited in Zhejiang province,we measured each participant's body height,body weight,waist and hip circumferences,and blood pressure.The observers administered a standardized questionnaire to collect information on smoking habits, alcohol consumption and use of antihypertensive drugs.Venous blood was sampled for biochemical measurements.Echocardiography was performed on each subject according to the recommendations of the American Society of Echocardiography.LVH was diagnosed by the M-mode echocardiography,according to left ventricular mass(LVM), calculated by the use of the Devereux formula.Both the stepwise linear regression and stepwise logistic regression were used in search for risk factors of LVH.Results:Overall,the prevalence of LVH was 12.7%for concentric remodeling,3.1%for eccentric hypertrophy and 1.9%for concentric hypertrophy.With adjustments for age,sex,body height and body weight, systolic blood pressure(p<0.01),pulse rate(p=0.01),use of antihypertensive drugs(p=0.06),serum total cholesterol(p=0.08)and serum triglycerides(p=0.04)were independent determinants of LVM.In logistic regression,age(OR=1.16)and systolic blood pressure(OR=1.19) were independent determinants of LVH.Conclusions:In Chinese population the prevalence of LVH increases with age and systolic blood pressure.2.The research of prevalence and determinants of left ventricular diastolic dysfunction.Objective:The objective of this study was to determine the prevalence and determinants of left ventricular diastolic dysfunction(LVDD)in a Chinese population.Methods:Echocardiography was performed on each subject according to the recommendations of the American Society of Echocardiography. LVDD was evaluated by pulse-wave Doppler examination of mitral valve, pulmonary venous inflow and the left atrial volume index.Both the stepwise linear regression and stepwise logistic regression were used in search for risk factors of LVDD.Results:Overall,the prevalence of LVDD was 13.7%for impaired relaxation,and 3.4%for pseudonormal and restrictive pattern.With adjustments for age,sex,body height and body weight,diastolic blood pressure(p<0.01),pulse rate(p<0.01)and plasma glucose(p=0.09) turned out to be independent determinants of E/A ratio.In logistic regression,age(OR=3.00),diastolic blood pressure(OR=1.40),body mass index(OR=1.16)and pulse rate(OR=1.03)were determinants of LVDD. Conclusions:In Chinese population the prevalence of LVDD increases with age,diastolic blood pressure,body mass index and pulse rate.3.The research of the impact of the Metabolic Syndrome on cardiac structure and function in a Chinese populationObjective:To investigate the association of the metabolic syndrome(MS) and its components with cardiac structure and function in Chinese.Methods:Echocardiography was performed on each subject according to the recommendations of the American Society of Echocardiography for the measurement of LAVI,LVEDV,LVMI,LVEF,E/A ratio,DTE,and Tei index.Results:843 subjects included 288(34.2%)women,and 191(22.7%) hypertensive patients,of whom 82(42.9%)took antihypertensive drugs. Compared to subjects in normal group,MS patients had significantly lower LVEF(P=0.049)and E/A ratio(P<0.001),and higher LAVI, LVEDV,LVMI,DTE(P<0.001)and Tei index(P<0.001).Moreover, LVEF and E/A ratio decreased,and LAVI,LVEDV,LVMI,DTE and Tei index increased with the number of MS components.Conclusions:MS and increased number of its components were associated with the impairment of cardiac structure and function.