Evaluation Of Relativity Between Left Ventricular Structure And Blood Pressure And The Function Of Left Ventricular Myocardium In Patients With Primary Hypertension By Echocardiography

Part ? Evaluation of relativity between left ventricular structure and blood pressure in patients with primary hypertension by echocardiography.Objective: To evaluate the change of left atrial and left ventricular structure and the relativity between left atrial and left ventricular structure and blood pressure in patients with essential hypertension.Methods: A retrospective analysis of hospitalized in the Department of Cardiology in the Second Affiliated Hospital of Dalian Medical University of hypertension from 233 cases,were treated by conventional echocardiography,including the patients of normal left ventricular configuration,left atrial aggrandizement 92 cases(group A)the patients of left ventricular hypertrophy,left atrial aggrandizement 81 cases(group B);the patients of left ventricular hypertrophy,left atrial normal 30 cases(group C);the patients of left atrial and left ventricula aggrandizement 30 cases(group D),there are156 patients has aortic valve calcification and 2 patients has left ventricular hypertrophy and left atrial aggrandizement and left ventricular outflow tract obstruction within 233 cases.Records of ultrasound parameters: end-systolic diameter of left atrial(Lad),left ventricular end-diastolic diameter(LVEDd),end-diastolic thickness of ventricularseptum(IVSTd),end-diastolic thickness of left ventricular posterior wall(LVPWd),Then calculated the left ventricular mass(LVM)and left ventricular mass index(LVMI),recorded the left ventricular ejection fraction(LVEF).Diastolic mitral valve flow spectrum and calculation the E peak and A peak ratio,aortic valve calcification and age(T),duration(T),systolic blood pressure(SBP),diastolic blood pressure(DBP).Results:1,(1),The age(Y),duration(T)and LAd of hypertension group C were all lower than those of hypertension A,B and D group,and the difference was statistically significant(p<0.05).(2)the systolic pressure(SBP)and diastolic pressure(DBP)in the group C of hypertension were higher than those in the group A,B and D,and the difference was statistically significant(p<0.05).(3)E/A of group D was higher than that of hypertension group A,B,C,and LVEF of group D was lower than group A,B,C and the difference was statistically significant(p<0.05).(4)IVSTd and LVPwd in the group B and group C of hypertension were higher than the group A and group D of hypertension and the difference was statistically significant(p<0.05).(5)The LVM and LVMI in group B,C,D were higher than those in group A,and the difference was statistically significant(p<0.05).2,(1)Lad in hypertensive patients increased with Y,T,SBP,DBP,and was positively correlated(r = 0.959?0.975?0.229?0.921,respectively).suggesting that the left atrial aggrandizement is most closely related to duration.(2)LVMI in hypertensive patients increased with T,SBP,DBP,and was positively correlated(r =0.945?0.964?0.952,respectively).suggesting that LVMI is most closely related to systolic blood pressure,and LVMI is uncorrelated with Y.Conclusion: The results suggest that the size of the left atrium is closely related to age,course of disease and diastolic pressure in patients with primary hypertension.The correlation is the most affected by the course of the disease and the least correlation with the systolic pressure,and the left ventricular hypertrophy is most affected by the systolic pressure.Part ?Evaluation of myocardium function of left ventricular hypertrophy in patients with primary hypertension by Three-dimensional speckle tracking image objective: To explore the myocardium function of left ventricular hypertrophy in patient of primary hypertension by three-dimensional speckle tracking image.Methods: Selected 60 patients with primary hypertension that treated in the Second Affiliated Hospital of Dalian Medical University,thereinto 30 patients that left ventricular hypertrophy and left atrium normal(group A),another 30 patients that left ventricular hypertrophy and left atrium aggrandizement(group B),in addition,selected30 healthy persons who was checkup in the same period,and there was regard as the contrast group.Then measured the routine parameters of two-dimensional ultrasound respectively for the group A,group B and the contrast group that included end-systolic diameter of left atrial(Lad),.left ventricular end-diastolic dimension(LVEDd).end-diastolic thickness of ventricular septum(IVSTd).end-diastolic thickness of left ventricular posterior wall(LVPWd).Then calculated the left ventricular mass(LVM)and left ventricular mass index(LVMI).Estimated the left ventricular ejection fraction(LVEF)by Simpson method.Analyzed the three-dimensional strain parameters of global of Left ventricular that included the parameters of Left ventriclar global longitudinal strain(LVGLS),left ventriclar global radial strain(LVGRS),left ventriclar global circular strain(LVGCS),and left ventriclar global area strain(LVGAS).Moreover,analyzed the three-dimensional strain parameters of part of Left ventricular that included the parameters of basal part of left ventricular,intermedius of left ventricular and the part of the Apex of heart of left ventricular for group A,group B and the contrast group.Results: 1.(1),Group A compared with group B compared with contrast group that the different of the LVEF had not the statistical significance(P>0.05),but,the LVEF of group A and the group B appear the rising trend.(2),the age of hypertension A groupwas lower than that of hypertension B group and control group,and the difference was statistically significan(P<0.05).(3),compared with the control group,the A group and B group of hypertension IVSd?LVPWT?RWT was increased,and the differences were statistically significant(P<0.05),(4),compared with the control group,A group,B group of hypertension LVMI increased and the difference is statistically significant(p<0.05);compared with group A of hypertension,group B of hypertension LVMI was increased,and the differences were statistically significant(p<0.05).2,LVGLS,LVGRS,LVGCS,LVGAS of group A and group B was reduced compared with the contrast group and the difference had the statistical significance(P<0.05);LVGLS,LVGRS,LVGCS,LVGAS of group B was reduced compared with the group A and the difference had the statistical significance(P<0.05).3,(1)Left ventricular systolic local peak strain of Longitudinal?Radial?Circumference?Area of the contrast group that the basal part of left ventricular overtopped the intermedius of left ventricular overtopped the part of the Apex of heart of left ventricular and the difference had the statistical significance(P<0.05).(2)Left ventricular systolic local peak strain of Longitudinal?Area that the basal part of left ventricular overtopped the intermedius of left ventricular overtopped the part of the Apex of heart of left ventricular(P<0.05).(3)Left ventricular systolic local peak strain of Radial?Circumference that the intermidius of left ventricular overtopped the basal part of left ventricular overtopped the part of the Apex of heart of left ventricular and the difference had the statistical significance(P<0.05).Conclusion: Three-dimensional speckle tracking image can detect the changes of left ventricular overall and local systolic function of left ventricular hypertrophy in patients with hypertension early,sensitive and accurate.