Relationship Between The Left Ventricular Wall Motion Changes And Platelet Activation In Hypertensive Patients With Left Ventricular Hypertrophy

Objective: Left ventricular hypertrophy(LVH)is an important target organ damage in hypertension,and it accompanied by changes in myocardial perfusion and left ventricular wall motion.By observing the relationship between platelet activation index and ventricular wall motion in hypertensive patients with LVH,we explore the effect of platelet activation and ventricular wall motion change on hypertension with LVH,and provide a new therapeutic target for the prevention and treatment of hypertension and its target organ damage.Methods: A total of 66 patients with essential hypertension were selected from April 2018 to October 2018 in the Department of Cardiology V,Second Affiliated Hospital of Dalian Medical University,and 15 patients with normal blood pressure were treated as control group.All patients were examined by echocardiography and the left ventricular mass index was calculated.According to the results of left ventricular mass index,hypertensive patients were divided into two groups: LVH group and non-LVH group.There were 43 cases in non-LVH group and 23 cases in LVH Group.The general data of the patient's sex,age,height and weight were recorded,the body mass index was calculated,and the indexes such as total cholesterol,fibrinogen and fasting blood glucose were tested.The level of platelet activation index CD62 p and PAC-1 was detected by flow cytometry.Ultrasonic bull's eye map was measured and calculated the color change segment and the left ventricular integral long axis,circumferential,area,and radial strain in the target map to reflect the changes in left ventricular wall motion.The relationship between platelet activation and left ventricular wall motion changes in hypertensive patients with LVH was analyzed.Result:(1)The level of platelet activation index CD62 p in the LVH group(51.78±6.82%)was significantly higher than that in the non-LVH group(41.28±4.73%)and the control group(32.61±4.02%)(P<0.05).The level of PDW in LVH group(15.95±1.01%)was significantly higher than that in the non-LVH group(14.99±2.11%)and the control group(14.04±1.77%)(P<0.05).There was no statistical difference between the three groups(P>0.05)in the platelet activation index PAC-1.(2)The number of color change segments in long axis strain of the bull's eye map in the LVH group(13.17±1.30)was significantly higher than that in the control group(6.50±1.92)and the non-LVH group(9.12±1.02)(P<0.05),the number of color change segment in radial strain of bull's eye map in LVH group(10.43±2.91)significantly higher than the control group(4.50±0.58)and the non-LVH group(6.67±2.31)(P<0.05).There was no statistical difference between the three groups(P>0.05)in the number of color change segments in the circumference and area strain of the bull's eye map.(3)The global longitudinal strain of the bull's eye map in the LVH group(8.94±2.99%)was significantly decreased than that in the control group(15.40±3.87%)and the non-LVH group(15.05±3.87%)(P<0.05),and the global radial strain of the bull's eye map in the LVH group(18.00±5.37%)was significantly decreased than that in the control group(32.92±5.51%)and the non-LVH group(32.54±5.85%)(P<0.05).There was no statistical difference between the three groups(P>0.05)in the global circumferential and area strain of the bull's eye map.There was no statistical difference between the non-LVH group and the control group(P>0.05)in the global longitudinal strain,circumferential strain,area strain and radial strain of the bull's eye map.(4)The result of Pearson correlation analysis showed that there was a positive correlation between the level of platelet activation index CD62p(51.78±6.82%)and the number of color change segments in long axis strain of the bull's eye map in the LVH group(13.17±1.30)(R=0.442,P<0.05).There was a negative correlation between the level of platelet activation index CD62p(51.78±6.82%)and the global long axis strain of the bull's eye map in the LVH group(8.94±2.99%)(R=-0.471,P<0.05).Conclusion:(1)The level of platelet activation in hypertensive patients with LVH was significantly higher than that in hypertensive patients and healthy people.(2)There was a correlation between platelet activation level,color change segment and strain rate in hypertensive patients with LVH,and with the increase of platelet activation level,color change segment increased and strain rate decreased.It is suggested that the changes of platelet activation may be efected in the change of ventricular wall motion in hypertensive patients with LVH.