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Relationship between left ventricular diastolic function and arterial elasticity in patients with early essential hypertension |
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Abstract ObjectiveTo investigate the relationship between left ventricular diastolic function and arterial elasticity in the patients with early essential hypertensive(EH). MethodsBoth of conventional ultrasound and tissue Doppler imaging(TDI) were utilized for detecting the left ventricular diastolic function separately in 42 patients with early EH(early EH group) and 54 healthy controls(control group). In the TDI mode, motion velocity indexes including early diastolic motion velocity(e′) and late diastolic motion velocity(a′) were measured at four separate sites of mitral annulus—the septum, and lateral, anterior and inferior wall of the left ventricle. The average early diastolic peak velocity(motion velocity of mitral annulus)(E/e′) and the average e′/a′ were calculated. The brachialankle pulse wave velocity(baPWV), anklebrachial index(ABI) and toebrachial index(TBI) were measured in all the subjects. The two sets of data were finally compared and analyzed. Results(ⅰ) Values of peak velocity of blood flow(E and A) did not vary from early EH group to control group. TDI showed an obvious decrease of the average e′ and e′/a′ in the early EH group\[the average e′: (8.86±1.87) m/s vs. (9.95±1.77) cm/s; the average e′/a′: (0.88±025) cm/s vs. (1.02±0.22) cm/s, P<0.05\]. The value of the average E/e′ in the early EH group was higher than that in the control group\[(8.67±2.4) cm/s vs. (7.03±2.51) cm/s, P<005\]. (ⅱ) The value of baPWV in the early EH group significantly increased if compared with the control group\[(1562.05±276.84) m/s vs. (1344.47±137.49) m/s, P<0.05\]. Although the values of ABI and TBI in the early EH group were in normal ranges, they were significantly reduced if compared with the control group(ABI: 105±0.08 vs.1.11±0.05, TBI: 0.74±0.11 vs. 0.83±0.04; P<0.05). (ⅲ) The index of baPWV was positively correlated with the average E/e′ and negatively correlated with the average e′/a′ in the early EH group(r=0.24, -0.23; P<0.05); ABI and TBI were negatively correlated with the average E/e′(r=-0.17,-016; P<005), and positively correlated with the average e′/a′(r=0.28, 0.18; P<0.05). ConclusionArterial wall stiffness can not only be witnessed in the early phase of EH, but with the increasement of arterial stiffness small arteries are involved, the severity of which is proportional to the degree of left ventricular diastolic hypofunction.
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