Characteristics Of Heart Structure And Function In Patients With Type2Diabetes Mellitus And Essential Hypertension

ObjectiveTo evaluate the changes of heart structure and function in patients with type2diabetes mellitus and essential hypertension.MethodsAccording to the principle of stratified random,Study groups were composed of79with type2diabetes mellitus and essential hypertension,39with diabetes,85patients with hypertension,and75healthy participants. Echocardiography was used to measure groups of patients with cardiac structure and function indexes. Indexes be compared. At the same time, all of the patients underwent detailed pathography, physical examination and determination of glycosylated hemoglobin (HbAlc), urinary albumin excretion rate (UAER), plasma N-terminal pro-brain natriuretic peptide in type B (NT-proBNP), serum lipids, blood urea nitrogen, serum creatinine, uric acid and other relevant laboratory parameters. The two groups were compared with t Test or Mann-Whitney Test.Many groups were compared with variance analysis or Kruskal-Wallis Test. Pearson or Spearman is used in the analysis of correlation between factors.Results1. Assessment of heart structure characteristics and the influence factors in patients with Type2diabetes mellitus combined with hypertension by Echocardiography.(1) The changes of cardiac structure in patients with Type2diabetes mellitus combined with hypertension:Compared with the control group, IVSTd,IVSTs,PWTd,PWTs,RWT,LVM-AL, LVM-L,LVMi-AL,LVMi-L,LAD,LAV,LAVi,RA-D2,RA-A,RV-D1,RV-D3and PA of Type2diabetes mellitus combined with hypertension group were singnificantly increased (P<0.05or P<0.01). LVIDi and LVEF of Type2diabetes mellitus combined with hypertension group were less than that of control group (P<0.05or P<0.01).(2) IVSTs、PWTd and RWT of type2diabetes mellitus combined with hypertension group were greater than simple type2diabetes group but Aortic-a, Aortic-v were less than simple type2diabetes group. IVSTd, PWTs, LVM-AL, LVM-L, LVMi-AL, LVMi-L, LAD, LAV, LAVi, RA-D2, RA-A, RV-D1, RV-D3and PA of type2diabetes mellitus combined with hypertension group were not statistically different but increased obviously than simple type2diabetes group.(3) Analysis of influence factors of cardiac structure in patients with Type2diabetes mellitus combined with hypertension:LVIDi, IVSTd,PWTd,RWT,LVM-AL and LVMi-ALwere positively correlated with BMI, height, weight, body surface area, waist, hips, waist hip ratio, HbAlc,UAER,NT-proBNP,Cr and UA (P<0.05or P<0.01). LAD,LAV, LAVi, RA-D2, RA-A, RV-D1and PA were positively correlated with height, weight, body surface area, BMI, waist and hip (P<0.05or P<0.01).2. Assessment of heart function characteristics and the influence factors in patients with Type2diabetes mellitus combined with hypertension by Echocardiography.(1) The changes of cardiac function in patients with Type2diabetes mellitus combined with hypertension:Compared with the control group, E/A,E’L,E’L/A’L,E’s,A’s and E’s/A’s of Type2diabetes mellitus combined with hypertension group were decreased (P<0.01). A wave,DT,E/E’L,E/E’s,M-E/E’ and FPV of Type2diabetes mellitus combined with hypertension group were more than that of control group (P<0.05or P<0.01).(2) E/E’s of type2diabetes mellitus combined with hypertension group were greater than simple type2diabetes group(P<0.05) but E/A,E’s and E’s/A’s were less than simple type2diabetes group(P<0.05or P<0.01). E’L,E’L/A’L and A’s of type2diabetes mellitus combined with hypertension group were not statistically different but increased obviously than simple type2diabetes group.(3) Analysis of influence factors of cardiac function in patients with Type2diabetes mellitus combined with hypertension:A peak, E/A and A-dur were correlated with age, body weight, body surface area, waist-to-hip ratio, LVIDd, LVIDs, RV-D2, RA-D1, E peak, E’s, A’s, E’s/A’s and M-E/E’(P<0.05or P<0.01); E’s, A’s, E’s/A’s, E/E’L, E/E’s and M-E/E’ were correlated with age, height, Cr, NT-proBNP and PA (P<0.05or P<0.01).Conclusion.1. Left ventricular hypertrophy and left atrial expand were higher in patients with type2diabetes mellitus combined with hypertension than simple type2diabetes independent of age, height, weight, BMI, body surface area, waist, hips, waist hip ratio, bloodlipid,and were significantly correlated with systolic blood pressure and diastolic blood pressure.2、Compared with nonhypertensives diabetic group, left ventricular diastolic function of type2diabetes mellitus combined with hypertension were serious reduced.3. Among the many parameters evaluating diastolic function in patients with type2diabetes mellitus combined with hypertension, LAVi,E’ and E/E’ were better effectively ones. 4. Type2diabetes mellitus combined with hypertension patients with left ventricular systolic dysfunction were reduced. Left ventricular systolic dysfunction of type2diabetes mellitus combined with hypertension group were not statistically different than simple type2diabetes group. LVEF and E/E’ is negative correlation.5. Hypertension significantly increased damage of heart structure and function in patients with type2diabetes mellitus.