| BackgroundMore and more people are concerned about the increase of senile diabetes type2patients with hypertension. The prevalence in recent years is showing an increase, not only because of the acute and chronic complications seriously affect people’s health, but also the two combined together affect the multi-system. This causes problem with eye, kidney, heart, blood vessels and other tissues and organs of chronic progressive disease, dysfunction and regression. Sever illness or stress can lead to acute serious metabolic disorders, which causes declined quality of patients’life, shortened life expectancy, increased mortality and severely threatens people’s living quality.Glycosylated hemoglobin (HbAlc) is increasingly brought to the attention of the clinical practice. Glycosylated hemoglobin is a combination of hemoglobin and sugars (such as glucose, glucose6-phosphate or1.6-acid fructose) by non-enzymatic in red blood cells. The synthesis process is slow and irreversible. Since the longevity of the red blood cells runs approximately120days in the blood, it can reflect patients nearly8and12weeks blood glucose levels. It is irrelevant to the fasting plasma glucose, insulin therapy affects and more intuitive reaction on their blood glucose levels. Therefore, a long period of control of HbAlc for diabetes is one of the main monitoring indicatorsN-terminal pro-brain natriuretic peptide (NT-proBNP) is of great value for the diagnosis of cardiac failure, differential diagnosis and prognosis and even for the guide treatment. It has become an internationally recognized plasma marker for diagnosing cardiac failure. Clinical application of plasma NT-Pro BNP concentration can be used as a stable and sensitive indicator of evaluation of cardiac function. It also can be an effective predictor for the severity of myocardial ischemia and cardiac function. The continuous rise of NT-pro BNP level, the incidence rate and increasing mortality of cardiovascular, poor prognosis, prediction of sudden death in patients with cardiac failure is a strong independent predictorEchocardiographic evaluation of the left ventricular systolic and diastolic function which has been widely used and recognized has the advantages of non-invasive. It is simple and reproducible. Left ventricular systolic dysfunction is due to the reduced ability of the myocardial contractile, this leads to stroke volume decrease, left ventricular end-systolic volume increase. Left ventricular ejection fraction (LVEF)-reduce and left ventricular diastolic dysfunction is caused by myocardial structure or physiological abnormalities, ventricular wall compliance reduce and blood returning heart chamber block are also effects. The study is to detect an aggregate indicator of HbAlc and observe its function in left ventricular dysfunction in hypertensive and senile diabetes type2patients.Objective To evaluate the relationship between glycated hemoglobin and left ventricular cardiac function in elderly patients with type2diabetes mellitus and hypertensionMethods A total of153cases of elderly patients with type2diabetes mellitus and hypertension were divided into two groups:group I(HbAlc <7%) and group II(HbAlc≥7%). Echocardiography heart structure parameters, including left ventricular end diameter diastolic(LVED), left ventricular end-systolic diameter(LVESD), interventricular septum thickness at end-diastole(IVSd), left ventricular posterior walldepth(LVPWD), left ventricular ejection fraction(LVEF) were observed. The plasma level of NT-proBNP was detected by ELISA.Results There were no statistical difference between the two groups in age, gender ratio, diabetes and hypertension duration, blood pressue, body mass index and blood lipid level Color doppler echocardiogram showed that cardiac structure parameters (LVED, LVESD, IVSd, LVPWD)in group II were significantly higher than those in group I (P<0.05). LVEF (68.94%±4.75%vs65.33%±7.79%, P<0.05) and NT-proBNP (747.135±1223.51ng/L vs116.37±110.54ng/L, P<0.05) in group II were also significantly higher compared in group I. Pearson correlation analysis show that the positive relationship existed between serum NT-proBNP and HbAlc (R=0.244, P=0.024). NYHA heart function classification compared with HbAlc levels, HbAlc level rise with deterioration of NYHA heart function classification.Conclusion More significant cardiac structural change were observed in higher HbAlc patients with type2diabetes mellitus and hypertension. Positive relationship existed between serum NT-proBNP and HbAlc. |
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