Relationship Between Myocardial Microcirculation And Cardiac Chronotropic Response And Other Factors In Patients With Essential Hypertension

Objective: By comparing myocardial microcirculation with cardiac chronotropic re sponse and other related indicators in patients with essential hypertension.The aim o f this study is to explore the relationship between myocardial microcirculation and cardiac hronotropic response and other factors on myocardial microcirculation in pat ients with essential hypertension.This sthdy is determine to make more reasonable decisions for early diagnosis and prevention of myocardial microcirculation injury in patients with essential hypertension.Methods: A total of 74 patients with essential hypertension who were hospitalize d in the department of cardiology of Sichuan Provincial People's Hospital from Jun e 2018 to January 2020 were recruited.Treadmill exercise stress echocardiography(TESE)was used to detect the relevant indicators of cardiac variability,and myocar dial contrast echocardiography(MCE)was used to complete the real-time evaluation of myocardial microcirculation perfusion.According to the myocardial microcirculat ion imaging,it was divided into normal group and abnormal group.Age,gender,b ody mass index(BMI),smoking and drinking history,blood glucose,blood lipid,in flammatory factors,basal blood pressure,cardiac chronogenic indicators and TESE parameters were collected.The differences of each index between the two groups w ere compared to analyze the relationship between cardiac microcirculation and cardi ac chronotropic response and other factors in patients with essential hypertension.Result:1)The average age of the study subjects was 52.07 ± 9.65 years old,the majority were males(62.16%),and the mean BMI was 25.47 ± 2.87.The average values of triglyceride(TG)in blood glucose and lipid were higher than the normal range,and the average values of blood sugar,total cholesterol(TC),low density lipoprotein(LDL-C),and high density lipoprotein(HDL-C)were within the normal range.The basal blood pressure level of the systolic blood pressure in the clinic was higher than the mean value of the 24-hour mean systolic blood pressure and the central arterial systolic blood pressure(CSBP).The mean values of inflammation indexes were all within the normal range.The mean values of the resting heart rate and the peak exercise heart rate in the cardiac chronological index are within the normal range,and the mean value of the chronotropic response index(CRI)is lower than the normal range.Myocardial microcirculation imaging was normal in the included population,accounting for 74.32%,and abnormality was 25.68%.2)Compared with the normal group of hypertensive myocardial microcirculation:(1)There was no significant difference in general conditions and comparison of blood lipids and blood glucose(P> 0.05).(2)The high-sensitivity C-reactive protein(hs CRP)increased in the inflammation index;(3)In the basal blood pressure level,the central arterial systolic blood pressure(CSBP)increased;(4)Resting heart rate,peak heart rate,heart rate reserve,average heart rate,and CRI all decreased;(5)In the TESE parameters,peak exercise systolic and diastolic blood pressure increased,left ventricular end-systolic volume(LVESV)increased,interventricular septal thickness(IVST)and left ventricular posterior wall thickness(LVPWT)increased,and metabolic equivalents(METs)Decreased,decreased exercise time,decreased left ventricular ejection fraction(LVEF)after exercise,and increased the number of ST segment changes.The above differences were statistically significant(P <0.05).3)Binary logistic regression analysis of myocardial microcirculation and cardiac chronology and other related factors in patients with hypertension: CRI,post-exercise LVEF,peak systolic blood pressure,LVPWT,hs CRP are related to myocardial microcirculation damage,and this relationship is independent Existence,(P <0.05).Conclusion:1.Chronotropic response(CR)abnormalities in patients with essential hypertension are mainly chronotropic incompetence(CI).When the chronotropic response index(CRI)decreases,the risk of myocardial microcirculation injury increases.2.After exercise,LVEF decreases,peak systolic blood pressure increases,and the risk of myocardial microcirculation injury increases.3.LVPWT and hs CRP are independent risk factors for myocardial microcirculation injury in patients with essential hypertension.4.CSBP,peak heart rate,average heart rate,heart rate reserve,peak diastolic blood pressure,METs,IVST,exercise time,and post-exercise LVESV may participate in the process of myocardial microcirculation injury in patients with essential hypertension.