Clinical Study On The Relationship Between The Updated Left Ventricular Geometry And The Structure And Function Of Right Ventricle In Hypertensive Patients

Objective:We sought to evaluate the structure and function of the right ventricle in different updated left ventricular geometry in hypertensive patients.Methods:According to the updated left ventricular geometry,based on LV mass index(LVMI),LV end-diastolic diameter(LVIDd)and relative wall thickness(RWT),all subjects were divided into six different groups: normal geometry,concentric remodeling,eccentric nondilated LVH,concentric nondilated LVH,eccentric dilated LVH and concentric dilated LVH.According to LVMI,all the patients were also divided into LVH group and non-LVH group.The structural parameters of the right ventricle included the diameter of the right ventricle and the thickness of the right ventricrlar free wall.The systolic function parameters included tricuspid annular plane systolic excursion(TAPSE),TDI peak systolic velocity of tricuspid annulus(St),right ventricular area change fraction(RV FAC).Diastolic function parameters included(E/A)t,(e'/a')t and(E/e')t.Take the average of 3 cardiac cycles of all parameters.Blood pressure was measured by taking the average value of three consecutive measurements in the sitting position 2 min apart after5-10 min rest.Sex,age,blood glucose,triglyceride and cholesterol levels were recorded in six groups.Results:(1)When compared all the parameters in LVH group with that in the non-LVH group,we have the following results: the thickness of the right ventricular wall was thickened and the diameter of the right ventricle increased,TAPSE,St,RV FAC,(E/A)t,(e'/a')t decreased,((E/A)t,(e'/a')t were both Less than 1),(E/e')t increased.The difference between the parameters was statistically significant(p < 0.01).(2)The thickness of right ventricular wall in concentric dilated LVH and concentric nondilated LVH was significantly higher than other groups(p < 0.01).The diameter of right ventricle in eccentric dilated LVH was significantly larger than other groups(p < 0.01).RV FAC,TAPSE,St was significantly lower in concentric nondilated LVH and concentric dilated LVH than in normal geometry,and the difference was statistically significant(p < 0.01).(E/A)t and(e'/a')t were less than 1 in each of the six groups,and were significantly lower in the concentric dilated LVH group than in the normal geometry group and the difference was statistically significant(p< 0.01).(E/e')t was significantly higher in concentric dilated LVH,concentric nondilated LVH and eccentric dilated LVH groups than in normal geometry and the difference was statistically significant(p< 0.01).(3)The left ventricular diastolic diameter in concentric dilated LVH group was increased significantly.RWT increased significantly in concentric remodeling,concentric nondilated LVH and concentric dilated LVH groups.LVMI increased significantly in concentric dilated LVH and eccentric dilated LVH groups,and the difference was statistically significant(p< 0.01).LV systolic function reduced significantly in concentric dilated LVH and eccentric dilated LVH groups,and the difference was statistically significant(p< 0.01).LV diastolic function reduced significantly in concentric dilated LVH and eccentric dilated LVH groups,and the difference was statistically significant(p< 0.01).(4)Mean systolic and diastolic blood pressure increased significantly in concentric nondilated LVH and concentric dilated LVH,and the difference was statistically significant(p< 0.01).There was no significant difference in sex,age,blood glucose,triglyceride and cholesterol levels among the six groups.Conclusion:(1)Hypertension affects the structure and function of right ventricle,and the changes of the right ventricle are related to the changes of the left ventricle.(2)The structure and function of right ventricle in different updated left ventricular geometry in hypertensive patients are different,and in concentric dilated LVH,concentric nondilated LVH and eccentric dilated LVH,the damage to the right ventricle was the most significant.