| Backgrounds and Objections:With the improvement of living strandard, the incidence of hypertension and diabetes is higher than before. And hypertension associated with diabetes is common, especially in the older patients. This allows the proportion of people with left ventricular diastolic dysfunction in the population further increased, thus affects the quality of people's daily lives. Then adverse diagnosis will delay the treatment, it will make the disease disorder, and the prognosis is poor.The main causes of diastolic dysfunction is age, hypertension and coronary heart disease. Hypertension can cause left ventricular hypertrophy, accompanied by the myocardial fibrosis which induced by myocardial interstitial edema, increasing of collagen metabolism and myocardial cells'necrosis. Then myocardial relaxation decreased while the stiffness increased, so that left ventricular diastolic dysfunction, causing the increasing of left ventricular filling pressure, leading to the increasing of left atrial afterload. The body meet the needs of left ventricular filling by increasing the atrial wall tension, thereby leading the myocardial hypertrophy and eventually left atrial enlargement. Studies also showed that the risk of diastolic dysfunction in patients with diabete is higher compared with non-diabetic people. Fuchenbush found that the high blood sugar and insulin resistance are directly related with diastolic dysfunction and heart failure, in addition to coronary heart disease and hypertension. And insulin resistance on cardiac structure and function may be associated with hemodynamic changes, the cardiac hypertrophy stimulated through the insulin receptor or insulin-like growth factor receptor, the increasing of myocardial cells'protein synthesis stimulated by the protein glycosylation leaded by the reduced insulin sensitivity and chronic hypoxia leaded by myocardial microvascular disease.TDI is a kind of innovative technologies by using ultrasonic technology to test wall motion, getting the direct frequenct shift signal of myocardial tissue, quantitative measurement of wall motion. It focuses on the reaction wall mechanical movement, rather than blood flow changes, relatively speaking, its assessment of diastolic function is not related with the load of heart , blood pressure, valve status and the impact of fluid dynamics. It is with high sensitivity and objective, and gradually becomes the"golden indicators"of noninvasive cardiac diastolic dysfunction.Since hypertension and type 2 diabetes on left ventricular diastolic function has been extensive research, and the impact of left ventricular diastolic dysfunction is assured. So the paper will no longer analyze it by compared with the control group, and targeted hypertension associated with diabete on left ventricular diastolic dysfunction. View to increasing attention with the patients with type 2 diabetes and hypertension, so that paying attention with the left ventricular diastolic dysfunction and left ventricular remodeling dued by diabete when making choice of drugs that can decrease the blood pressure. Emphasize on improving the abnormal glucose metabolism and improving insulin sensitivity when decreasing the blood pressure. And by comparing the color flow Doppler and TDI examination, described the advantage of TDI on the diagnosis of left ventricular diastolic dysfunction. Improved diagnostic methods and therapeutic levels will definitely improve.Methods: A retrospective study from January 2008 to February 2010 in hospital hypertension and type 2 diabetes clinical data, patients that meet the criteria of the study were divided into essential hypertension (EH) group (n = 220), 2 type diabetes mellitus (T2DM) group (n = 63) and hypertensive patients with type 2 diabetes mellitus (EH + T2DM) group (n = 108). Measure left atrial diameter, left ventricular end diastolic diameter, interventricular septum thickness and left ventricular posterior wall thickness in M-mode by echocardiography, using Devereux formula to calculate left ventricular mass index and relative wall thickness, and classified the patients into different left ventricular geometry. Measure e and a peak velocity with color flow Doppler Tissue Doppler imaging. Measure e 'and a' peak velocity by using DTI, and use the ratios <1 for diagnostic criteria of left ventricular diastolic dysfunction. Then we used SPSS11.5 software to analyze and compare the general information, biochemical markers and echocardiogram results of the three groups.Results: The age of EH + T2DM group is higher than the EH group and T2DM group (p <0.05), while SBP and DBP of it are less than the EH group (p <0.05), TG of it is less than the T2DM group (p <0.01); the diabetes duration, SBP and DBP of EH + T2DM group were higher than the T2DM group (p <0.05); TG of T2DM group was higher than EH group (p <0.001), and Cr of it is less than EH group (p <0.01). The interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass index and relative wall thickness of EH + T2DM group were higher than the EH group and the T2DM group (p <0.01). The patients with concentric hypertrophy in EH + T2DM group were significantly more than the EH group and the T2DM group (p <0.001), while the incidence of normal configuration is less than the EH group and the T2DM group (p <0.01). The e ' of EH + T2DM group is significantly lower than the EH group and T2DM group, whereas left atrial diameter was greater than the EH group and the T2DM group (p <0.05). The a ' of EH + T2DM group significantly is less than the T2DM group, but a, e' / a ' of it were higher than the T2DM group (p <0.05). The patients with e/a<1 or e'/a'<1 in EH group and the EH+T2DM group are significantly greater than the number of T2DM group(p<0.05). Diagnosing diastolic dysfunction with the ratio of e/a do exist a large number of "pseudo-normalization." The risk of left ventricular diastolic dysfunction occurs in EH+T2DM group was 1.8 times as much as T2DM group. The risk of it in EH group is 1.4 times as much as T2DM group. The risk factors of left ventricular diastolic dysfunction is blood pressure classification, hypertension and overweight.Conclusion:1 Mitral annular velocity measured by TDI is a independent parameters for the assessment of diastolic function without considering preload, it can identify false normalization of blood flow, finding early left ventricular diastolic function impaired.2 The effect of type 2 diabetes on left ventricular diastolic dysfunction is more than that of hypertension. It will maximize left ventricular hypertrophy, left ventricular abnormalities and left ventricular diastolic dysfunction and so on, accelerate the progression of disease, when the hypertension and type 2 diabetes mellitus occur together.
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