Using Quantitative Tissue Velocity Imaging Technique To Evaluate Right Ventricular Diastolic Function Of Patients With Primary Hypertensive

Objective: Using quantitative tissue velocity imaging(quantitative tissue velocity imaging, QTVI)technology to extract tissue doppler frequency shift signal of three tricuspid annulus, mitral annularside wall and ventricular septal myocardium in patients with primary hypertension,at the same time recorded in late diastole(Am) and early diastolic(Em)peak velocity and calculate the ratio of Em/Am, to explore the right ventricular diastolic function in patients with primary hypertension in different course of disease, the level change trend.Methods: to selected of 151 patients with primary hypertension(hypertension group), classified according to the different course of disease and blood pressure levels, normal healthy people(control group)60. Applied pulsed Doppler heart to routine measure and converted to Doppler tissue imaging(DTI) image, at the same time recorded peak velocity of late diastolic(Am) and early diastolic(Em) of four parts of the apical four chamber view, left atrioventricular valve ring at septum(LAVP1), left atrioventricular valve ring at lateral wall(LAVP2), right atrioventricular valve ring at lateral wall(RAVP1), right atrioventricular valve ring at septum(RAVP2) and calculate the ratio of Em/Am. Results: The ratio of Em/Am <1 incidence between hypertension group and control group of four points of comparison: the rate of diastolic dysfunction of RAVP1, RAVP2, LAVP1 and LAVP2 in hypertension group were higher than in the control group, the difference was statistically significant(P <0.05); RAVP1 and LAVP2 of Em and Em/Am of LVH group in Hypertension group in were lower than NLVH group, the difference was statistically significant(P < 0.05); A comparison between the hypertension group in the 1 grade, 2 grade, 3 grade: RAVP1 in the three groups had similar rates of diastolic dysfunction, no significant difference(P>0.05), RAVP1, RAVP2, LAVP1, LAVP2 four points diastolic dysfunction rate increased with the increase of blood pressure level, thedifference was statistically significant(P < 0.05); The comparison between the different course of disease: diastolic function was only RAVP1 and other parts was normal that 1 ~ 4.9 years group was higher than 5 years ~ 9.9 years group and10 years group, the difference was statistically significant(P <0.05); four points of RAVP1, RAVP2, LAVP1 and LAVP2 did not appear at the same time can decrease diastolic case that RAVP1(76 cases) with only [RAVP2 and(or) LAVP1] occurred diastolic dysfunction was 61.8% of the cases(47/76), only LAVP2 diastolic dysfunction rate was 14.5%(11/76), LAVP2 diastolic dysfunction was significantly lower than that of [RAVP2 and(or) LAVP], the difference was statistically significant(P<0.05); Regression analysis showed that independent factors of diastolic dysfunction: the course of hypertension, the level of hypertension, age(P <0.05). Conclusion: 1.hypertensive patients with the course of development from the right ventricle to the left ventricle of heart is diastolic dysfunction in each range; 2. Patients in primary hypertension can occur right ventricular diastolic function decline, with the left ventricular developed course appeared compensative changes and develop into myocardial hypertrophy, which can lead to right ventricular remodeling and diastolic function decreased further;3. patients with primary hypertension increases with the duration, level, local cardiac diastolic function decreased rendered by the development of the right ventricle to interventricular septum and left ventricular, diastolic dysfunction of right ventricle changed earlier than the left ventricle; 4. In patients with primary hypertension diastolic decline the main factor is the duration of hypertension, second is level and age of hypertension.