| Objectives:Discuss the impacts of the level of plasma homocysteine on coronaryartery diseases(CAD)and left ventricular(LV)functions in female patients with hypertension.Methods:A case-control study was conducted enrolling 354 cases of female patients with hypertension hospitalized in the Hospital for From January 2015 to June 2016.according to their plasma homocysteine concentrations,these Patients were divided into 2 groups,plasma homocysteine concentration>10mmol/l H type hypertension group(240 cases),and<10mmol/l is a non H type hypertension group(114 cases),Comparison the two groups of patients with their basic data such as Body mass index,blood pressure,history of diabetes etc.and their major biochemical indicators such as Fasting blood glucose,glycosylated hemoglobin,triglyceride,total cholesterol,low density lipoprotein cholesterol.Coronary angiography and Color Doppler echocardiography was performed in two groups.According to the results of coronary angiography and color Doppler ultrasound,we analyzed and compared the characteristics of coronary artery disease and left ventricular systolic and diastolic function.Results:Compared to the H type hypertension group and non H hypertension group,two groups of patients with age[(65.58±12.64)vs(63.08±9.94),P>0.05],BMI[(25.10±3.65)kg/m~2 vs(24.79±3.52)kg/m~2,P>0.05],incidence of diabetes(25.42%vs21.93%),systolic blood pressure[(142.3±19.82)mmHg vs(138.2±17.89)mmHg,P>0.05],diastolic blood pressure[(85.3±13.51)mmHg vs(83.7±11.7)mmHg],P>0.05],fasting blood glucose[(6.48±2.24)mmol/l vs(6.35±1.87)mmol/l,P>0.05],HbAlc[(6.34±0.72)%vs(6.35±0.78)%,P>0.05],triglycerides(TG)[(1.708±1)mmol/l vs(1.635±0.828)mmol/l,P>0.05],total cholesterol(TC)(4.668±1.043)mmol/l[vs(4.671±0.811)mmol/l,P>0.05],low density lipoprotein cholesterol(LDLC)[(2.609±0.727)mmol/1 vs(2.589±0.57)mmol/l,P>0.05]show no significant difference.Coronary angiography showed the H hypertensive patients with severe coronary artery stenosis lesions(55.8%vs14.9%,p<0.05)is higher than the proportion of non H type hypertension group;The proportion of mild stenosis(1.7%vs 8.8%,p<0.05)and moderate stenosis(41.4%vs65.8%,p<0.0001)were lower than those in non H group.The H type hypertension group patients with three vessel disease ratio(33.8%vs6.1%,p<0.05)was higher than that of non H type hypertension group,two vessel disease ratio(14.6%vs8.8%,p>0.05)had no significant difference however,the proportion of single coronary artery lesions(56.7%vs74.6%,p<0.05)is lower than that of non H type hypertension group;H group of patients with hypertension before descending lesion ratio(70%vs49.1%,p<0.05)circumflex artery ratio(51.7%vs19.3%,p<0.05)and right coronary lesions ratio(62.5%vs23.7%,p<0.05)were higher than that of non H type hypertension group,two group of coronary artery in patients with left main lesion ratio(1.7%vs0%,p<0.05)show no significant difference.The score of coronary artery lesions in patients with type H hypertension[(23.96±12.71vs(10.055±7.46),p<0.05]was significantly higher than that of non H type hypertension group.The peak diastolic blood flow velocity A peak.Echocardiography showed H type hypertension group reflect left ventricular systolic function of left ventricular ejection fraction[(63.66±4.878)%vs(65.13±3.468)%,p<0.05]was lower than that of non H type hypertension group,and the left ventricular mass index[(141.89±2.73)g/m~2 vs(117.78±2.12)g/m~2,P<0.01]and left ventricular wall tension[(0.3944±0.0003)vs(0.3867±0.0062),P<0.01]was higher than that of non H type high blood group.In the reflection of the left ventricular diastolic function indexes,the H type hypertension group show their left ventricular isovolumic relaxation time[(72.475±3.526)ms vs(74.851±2.749)ms,P<0.05],E/A that the ratio of the peak E velocity of diastolic blood flow and the A peak velocity of late diastolic blood flow[(0.946±0.254)vs(0.984±0.325),P<0.05]were lower than that of non H type hypertension group.The peak diastolic blood flow velocity E peak in H type hypertension group[(73.84±13.92)ms vs(67.63±8.21)ms,P<0.05]was Higher than the non H type hypertension group.Two groups of patients with late diastolic peak flow velocity A peak[(82.91 ± 15.73)ms vs(76.15±18.12)ms P>0.05].early diastolic mitral annulus e' peak[(5.721 ±0.842)ms vs(5.799±1.035)ms,P>0.05],early diastolic mitral annulus a' peak[(9.115 +1.298)ms vs(8.999±1.158)ms,P>0.05],e'/a' that the ratio of early diastolic mitral annulus e' peak and a' peak[(0.645±0.124)vs(0.652±0.097),P>0.05],E/e' that the ratio of early diastolic blood flow velocity peak E and early diastolic mitral annulus e'peak[(13.181±2.854)vs(11403±2.382),P>0.05]compared no significant difference.Conclusions:Based on the above findings,this study concludes that H type hypertension patients witness a significant difference with non-H type hypertension patients in terms of CAD,LV systolic function and part of the LV diastolic function.Specifically,Female H type hypertension patients experience severer CAD and LV dysfunction.After exclusion of gender,age,smoking history,blood lipids,blood glucose and other factors,the escalated level of serum homocysteine may be the risk factor for CAD and LV dysfunction in female patients of hypertension... |
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