Assessment Of Left Ventricular Function In Hypertension By Quantitative Tissue Velocity Imaging

Objects:1 To investigate the difference of the left ventricular wall movement between normal people and patients with hypertension using quantitative tissue velocity imaging(QTVI)technique.2 To study the value of QTVI in assessing the left ventricular function in patients with hypertension.3 To provide the experimental evidence for judging the change of myocardial function in patients hypertension.Subjects and methods:A total of 130 consecutive subjects were divided into 3 groups:1 The control group consisted of 40 subjects(20 males and 20 female,age 29-62 years)without cardiovascular disease,hypertension,or diabetes mellitus who had no abnormal findings on physical examination or abnormalities on electrocardiographic or conventional echocardiographic examinations.2 A total of 90 patients whose blood pressure met the criteria for the diagnosis of hypertension established by WHO/ISH were admitted to the hypertension group.Hypertension was defined as a blood pressure of at least 140/90 mmHg or the use of anti-hypertension medications.Patients with secondary hypertension were excluded by physical and laboratory examinations.The hypertension group was consisted of 41 males and 49 females with age 33-70 years,and 0-480 months case history.The hypertension group was divided into two groups by the left ventricular mass index(LVMI).One group was the normal group without ventricular hypertrophy(nLVH)whose LVMI were within the normal range.And the other group is the left ventricular hypertrophy(LVH)group,whose LVMI were above the range.(normal LVMI male≤125g/m~2 female≤120g/m~2) Intra- and inter-group comparisons were performed with a one-way ANOVA test and post-hoc LSD-t test respectively.Univariate correlation was assessed by Pearson correlation coefficient.For all statistical procedures,SPSS statistical analysis software was used.A P value＜0.05 was considered statistically significant.Results:1 Comparisons of clinical data among three groups:Compared with the control group,systolic blood pressure,diastole pressure,pulse pressure,thickness of interventricular septal wall (IVSTd)and peak A mitral inflow velocity significantly increased in the nLVH group and LVH group(P＜0.001),while E/A ratio decreased significantly(P＜0.001).But E/A ratio was not significantly different between nLVH group and LVH group(P＞0.05).LVEF was also not significantly different among the three groups(P＞0.05).2 Comparisons of intra-group data in different left ventricular wall level:Left ventricular wall motion modes of the control and the two hypertension groups were similar to every other when analyzed in point of left ventricular wall velocity.The base level velocity was higher than the middle level(P＜0.001).3 Comparisons of intra-group systolic tissue peak velocity(Vs)among different left ventricular walls: In the three groups,comparisons of base Vs were similar,which showed that Vs of the free wall was higher than the interventricular septum.4 comparisons of inter-group data:Compared with the control group,Vs and early diastolic tissue peak velocity(Ve)on the base level and the middle level both decreased significantly in nLVH group and LVH group(P＜0.05-0.001),while latter diastolic tissue peak velocity(Va)on the base level and middle level were also not significantly different(P＞0.05).Ve/Va ratio was significantly different between the control group and nLVH group (P＜0.05).Compared with the nLVH group,Vs,Va and Ve/Vs of the base level and the middle level were neither not significantly different(P＞0.05)in the LVH group,whereas Ve was significantly different(P＜0.01).5 Comparisons of posterior wall data between intra-group and inter-group. Vs,Ve,Va on the base level of intra-group were higher than that on the middle level.Compared with the control group,Vs,Ve and Ve/Va of the base level and the middle level both decreased significantly(P＜0.05)in nLVH group and LVH group,and Va of the base level in nLVH group increased significantly (P＜0.05).Va of the middle level in the nLVH group and LVH group and of the base level in LVH group were not different significantly(P＞0.05). Compared with nLVH group,Vs on the base level and Ve on both the base and the middle level decreased significantly(P＜0.05)in LVH group,while Vs on the middle level and Va,Ve/Va on both levels in LVH group were not different significantly(P＞0.05).Conclusion:1.For the left ventricular remodeling,the systolic and diastolic modes of left ventricle have changed in the patients with hypertension,which showed that Vs,Ve decreased significantly. 2 Comparisons of Vs on the same level showed that Vs on the free walls were higher than interventricular septum.Compared with other walls, study on the posterior wall can reflect the change of hypertensive left ventricular systole and diastole modes more sensitively.3 Vs can reflect the systole function of the left ventricular more sensitively than LVEF.4 Compared with E/A,Ve,Ve/Va can reflect the diastole function of the left ventricular more sensitively.And within the two targets,Vs was better.When the total systole and diastole function of the left ventricular were still normal,Va did not change obviously.