Assessment Of Right Ventricular Function In Patients With Essential Hypertension By Real-time Three Echocardiography And Doppler Tissue Imaging

Objective: To assess the right ventricular function in patients with essential hypertension with real-time three dimensional echocardiography(RT-3DE) and doppler tissue imaging quantitatively.Methods: 128 cases with essential hypertension were chose by inpatient and outpatient between October,2013 and October,2014,they all conformed to the 2010 Chinese hypertension prevention guide,and among them,there were 67 males,and 61 females,the average age was 54.73±8.0. These patients were divided into four groups according to Ganau criteria:normal left ventricular construct group(NG group),centripetal remodeling of left ventricle(CR group),centripetal hypertrophy of left ventricular(CH group),centrifugal hypertrophy of left ventricle(EH group).Meanwhile,36 cases of normal people taking check-ups were enrolled as control group,among them,there were 18 males and 18 females,and the average age was 53.2 ± 7.28, There was no significant difference of the basic clinical features such as the sex,rate heart and year between the control group and the hypertension group.And all the echocardiography was performed with SIMENS ACUSON SC2000 ultrasound machine(Germany), with a 4Z1 c transducer(1.5-3.5MHz),and the Tom Tec software was equipped. First, normal 2D and M mode exams was being done,in the end diastolic period,the interventricular septum(IVST)and the left ventricular posterior wall(LVPW),left ventricular diameter(LV) and left ventricular ejection fraction(LVEF)were measured in parasternal long-axis,and on the same section,the right ventricular anterior wall(RVAW) and right ventricular(RV) was measured.In the Then all the people underwent the full volume three real-Time dimensional three echocardiography(RT-3DE).In the apical four chamber view, started the three dimensional reconstruction.After that, Tom Tec software was used to analyze the data, drew the outlines of the right ventricular,and adjusted them carefully to make them fit the actual structure.At last,The end diastolic volume(RVEDV),end systolic volume(RVESV), end diastolic stroke volume(RVSV) and right ventricular ejection fraction(RVEF), a volume-time curve and aright ventriculardiagrammatic figure were determined.Then also in the apical four chamber view,the DTI was activated, the sample volume was placed on the tricuspid valve mitral valve respectively,and then obtained the best peak velocity,and measured right ventricular filling pameters,the velocity of Ea,Aa,and the right ventricular isocolumetric relaxation time(IVRT)and calculated the Ea/Aa ration at the same time.Results: 1.There were no difference about age,sex,and heart rate between the contrast grup and essential hypertension(P>0.05).The diastolic pressure and systolic pressure of the four hypertension groups was higher than the control group,(P<0.05),and the diastolic pressure and systolic pressure of CH group and EH group was higher than other groupsp(P<0.05).2.The 2D parameters showed, IVSTd, LVPWTd and RWTof CR,CH and EH group were thicker than other groups, and the CH group was the thickest among all the groups(P<0.05)the LVEDd of CR,CH and EH group were lager than other groups,and the EH group was the largest among all the groups(P<0.05);The LVMI of the CH and EH group were higher than other groups and the EH group was the highest(P<0.05);The LVEF of CH and EH group were lower than other groups and the EH group was the lowest(p<0.05);RVAWTd of CH and EH group was thicker than other group(P<0.05).3.The RT-3DE parameters showed, the RVEDV and RVESV of EH and EH group were lager than other groups,and the EH group was the largest(P<0.05); The RVEF of CH and EH group were lower than the other groups,and the EH group was the lowest(P<0.05).4.The DTI parameters showed, Ea/Aa ratio of all hypertension groups were all smaller than 1, and the ratio decreased gradually(P<0.05),Ea reduced and Aa increased;and IVRT of all groups all increased according to the LV geometrical morphology(P<0.05).5.The heart function correlation between the left and right ventricular:RVEF and LVEF has correlation(r=0.39,P<0.01),Ea/Aa and e/a showed good correlation(r=0.67,P<0.05).Conclusions: 1.In the late stage of hypertension,the RV strcture would have the change of remolding, mainly was the RVAWTd become thicker;2.The RV systolic and diastolic function would be impaired, and the RV function might decline with different patterns of the LV, and the function of EH group was impaired the most; The diastolic dysfunction of RV has occurred before the systolic dysfunction;3.The left and right ventricular function has certain correlation,and the diastolic has better correlation beween two ventricular.4.RT-3DE and DTI is noninvasive and nonradiative, and easy to operate, thuscan be used as a simple and convenient technique to evaluate the right ventricular function of essential hypertension...