A Case Control-Study On Cardiac Structural Changes In Patients With Chronic High Altitude Polycythemia

Objective Case-control study method is applied to compare the changes in the structure of the heart in chronic high altitude polycythemia(CHAPC)patients and plateau healthy controls.Methods The 41 chronic high altitude polycythemia(CHAPC)patients diagnosed in the high mountain disease cardiology department of Tibet autonomous region people's hospital were chosen as the cases group in strict accordance with the inclusion and exclusion criteria,at the same time,41 plateau healthy people are as the healthy control group.1.Collected their following research indexes'data.(1)General information:gender,age,nationality,profession,stature,weight,smoking or drinking alcohol or not.(2)Clinical symptoms:with or without these clinical symptoms:headache,dizziness,dyspnea,heart palpitation,chest distress,hypodynami-a,bad night sleep or hypomnesia.(3)Signs:heart rate,blood pressure,blood oxygen saturation of fingers without oxygen inhalation(the above indexes need rest for 30minutes or more),with or without the signs of cyanosis,polycythemia face,conjunctival congestion,the second heart-sound enhancement of pulmonary valve area or edema.(4)Laboratory examination indexes:collect two groups of hem-oglobin(Hb),red blood cell counts(RBC),hematocrit(HCT),platelet counts(PLT),liver function[alanine aminotransferase(ALT),aspartate aminotra-nsferase(AST),serun total bilirubin(STB),conjugated bilirubin(CB),unco-njugated bilirubin(UCB)],Renal function[blood urea nitrogen(BUN),creatinine(Cr)],coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),plasma D-Dimer(D-Dimer),fibrinogen degradation product(FDP)],cardiac markers[myoglo-bin(MYO),cardiac kinase-MB(CK-MB),cardiac troponin I(cTn I)],fasting blood glucose(FBG),blood lipid:Serum total cholesterol(CHOL),trigly-ceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C).(5)Ultrasonic cardiogram indexes:left ventricular end diastolic diameter(LVDd),left ventricular end systolic diameter(LVDs),left atrial diameter(LAD),right ventricular diameter(RVD),aortic diameter(AOd),aorta ascending diameter(AAOd),right ventricular outflow tract inner diameter(RVOT),the main pulmonary artery diameter(PAD),The thickn-ess of the left ventricular posterior wall at end diastole(LVPW-d),interventricular septum thickness at end diastole(IVSd),right ven-tricular anterior wall thickness at end diastole(RVAWd),left ventricular fractional shortening(LVFS),Left ventricular ejection fraction(LVEF),E peak velocities(E)and A peak velocities(A)of mitral valve flow,the flow velocity and pressure gradient of pulmonary valve and aortic valve,heart valvular regurgitation.2.Calculate the body mass index(BMI),the ratio of peak E and A wave velocities of mitral valve(E/A)and pulmonary artery pressure of the two groups.3.Analysis the above data.Results 1.The blood oxygen saturation in CHAPC group is significantly lower than that in the healthy control group(P<0.05),and there is obvious hypoxemia in CHAPC group.The BMI of the CHAPC group is higher than that of the healthy control group(P<0.05).ALT,AST,STB,CB,UCB of the CHAPC group are higher than the healthy control group(P<0.05).The CHAPC group~'s APTT,PT,TT have extended than the healthy control group(P<0.05).the HDL-C of the CHAPC group is lower compared with the healthy controls~'group(P<0.05).The cTn I and CK-MB are a slight increasing in the group of CHAPC(P<0.05).The LVDd,RVD and LAD of the CHAPC group are of enlargement than the healthy control group(P<0.05).RVOT,PAD,AAOd and AOd are widened than the healthy control group(P<0.05),the thickness of RVAWd,LVPWd and IVSd are incrassated in CHAPC group than the healthy control group(P<0.05),thesedifferenceswasstatisticallysignificant.The structural proportion of the right ventricular enlargement,right ventricular hypertrophy,pulmonary hypertension and tricuspid regurgitation in CHAPC group are significantly higher than that in the healthy control group,these are significantly statistical differences(P<0.05).Conclusions 1.There are changes in the structure of the heart for chronic high altitude polycythemia patients,the main changes is right ventricular expansion and right ventricular hypertrophy.2.The chronic high altitude polycythemia patients also combined with other organs and systems function damage except the cardiac structural changes.3.The chronic high altitude polycythemia patients group have a high constituent ratio in hyoxemia and pulmonary hypertension than the healthy control group.