Relation Of Left Ventricular Remodeling To Levels Of Serum High Sensitivity C-reactive Protein In Patients With Essential Hypertentsion

Objective To observe the changes of serum high sensitivity C—reactive protein(hs-CRP)in the patients with essential hypertension (EH),which rusulted in different levels of left ventricular mass index,in order to study the clinical markers that influences hs-CRP,and explore the correlation of hs-CRP with left ventricular remodeling.Methods C-reactive protein , total cholesterol(TC) triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),urea nitrogen(BUN), creatinine(CR)and uric acid (UA) are measured in all the individuals ,including 114 patients with EH and 68 healthyiers. At the sme time , colour doppler echocardiography is accepted; the indexes include IVST,LVPWT,LVEDd,LVEDs,EF.Then left ventricular mass index (LVMI) is calculated.(LVM)(g)=0.8×1.04 [(LVEDd+IVST+LVPWT) 3-LVEDd3]+0.6. LVMI=LVM/BSA (g/m2). All the individuals are divided into EH group and control group.And the EH patients are divided into EH1,EH2,EH3 three groups based on blood pressure,at the same time,114 hypertensive patients were divided into A,B,C three groups based on different levels of hs-CRP.To compare levels of serum hs-CRP and LVMI of different groups and analyze the correlation of hs-CRP and left ventricular remodeling.Results1. Serum levels of hs- CRP are significantly higher in patients with EH than those of controls (P=0.000,P < 0.05).2. EH2,EH3 both had high serum hs-CRP levels than EH1,(P= 0.029,0.041,P<0.05),and there was no significant difference between EH2 and EH3 group(.P=0.073,P>0.05).3. All the EH patients were divided into 2 groups based on the level of hs-CRP,one was >3.0mg/L,the other was≥3.0mg/L,and the later had a significantly high LVMI than the former(P<0.05).4. B,C group both had high LVMI than A group,(p=0.019,0.010,p<0.05,lVMI of C group was higher than B group(P=0.000,P<0.05).5. Serum levels of hs-CRP had a positive correlation with SBP,IVST,LVPWT,TC,LDL- C,UA, (r= 0.386,0.463,0.342,0.351,0.311,0.387,P<0.05),and had no evident correlation with HDL-C,BUN,CR,LVEDd,LVEDs,EF(P>0.05).6. LVMI had a positive correlation with hs-CRP,r=0.571,(P<0.05)Conclusions(1)Serum levels of hs- CRP are significantly higher in patients with EH than those of controls。It suggests that there is different levels of tissue damage and inflammation reaction,which indicates that inflammation may participate in the occurence of hypertension and left ventricular remodeling。(2)In essential hypertension group ,LVMI is positively correlated with the level of hs- CRP. It suggests that hs- CRP may be the independent anticipation index of EH patients with left ventriclar reconstruction.(3)TC,LDL-C,UA has relationship with hs- CRP,reducing the levels of TC,HDL,and UA helps to improve the patient's condition.(4)hs-CRP reflects the severity of hypertension and left ventricular remodeling;it has some clinical significance to assess the patient's condition.