Relationship between arterial stiffness and systolic deformation in patients with hypertension

doi:10.3877/cma.j.issn.1672-6448.2015.12.006

Abstract

Abstract:

Objective

To investigate the effect of arterial stiffness on systolic deformation in hypertensive disease.

Methods

Sixty essential hypertensive patients were enrolled, including 25 cases with left ventricular normal geometric (group LVN) and 35 cases with left ventricular hypertrophy (group LVH) in the Affiliated Hospital of Qingdao University during July 2013 to March 2014. Thirty patients in the control group were enrolled in the same period. The peak systolic strains and strain rates were determined by using velocity vector imaging. Stroke volume was obtained by using real-time three-dimensional echocardiography. And pulse pressure/stroke volume was used as a surrogate index of arterial stiffness. Pulse pressure/stroke volume, the differences of strain and strain rate in three groups were compared by analysis of variance, and SNK-q test was used for further comparison between two groups. Multiple linear regression was performed to estimate predictors for systolic longitudinal deformation. Pearson′s correlation was used to analysis the relevance of systolic longitudinal strain and body mass index, triglyceride, left ventricular ejection fraction, age, left ventricular mass index, pulse pressure/stroke volume.

Results

Pulse pressure/stroke volume were (1.26±0.45) mmHg·m²·ml^-1, (1.53±0.59) mmHg·m²·ml^-1, (1.82±0.43) mmHg·m²·ml^-1 (1 mmHg=0.133 kPa) in the control group, LVN, LVH respectively. The systolic strains and strain rates in the control group, LVN, LVH were recorded as follows: systolic longitudinal strains were (23.60±1.94)%, (19.69±2.56)%, (17.34±2.48)%, the systolic longitudinal strain rates were (1.64±0.17) s^-1, (1.52±0.14) s^-1, (1.38±0.18) s^-1; the systolic radial strains were (28.69±5.2)%, (30.81±4.14)%, (26.53±3.50)%, the systolic radial strain rates were (2.51±0.56) s^-1, (2.60±0.45) s^-1, (2.00±0.41) s^-1; the circumferential strains were (24.50±5.21)%, (24.01±4.60)%, (21.00±3.70)%, the circumferential strain rates were (1.38±0.38) s^-1, (1.30±0.30) s^-1, (1.10±0.26) s^-1. Pulse pressure/stroke volume was higher in LVN and was more pronounced in the LVH group compared with the control (LVN/LVH with the control group: q=2.90, 6.56, LVN with LVH: q=3.22, all P<0.05). The strains and strain rates in LVH were lower than those of LVN and the control group, and the differences were statistically significant. (longitudinal strains: q=15.22, 5.43; longitudinal strain rates: q=8.88, 4.54; radial strains: q=2.85, 5.36; radial strain rates: q=6.10, 6.81; circumferential strains: q=4.42, 3.61; circumferential strain rates: q=5.04, 3.42; all P<0.05). The strains and strain rates in LVN were lower than the normal group, the significant differences of the longitudinal strains and longitudinal strain rates were found (q=8.73, 3.77, both P<0.05) while there were no statistically significant differences of radial strains and radial strain rates, circumferential rates and circumferential strain rates. In a multivariate analysis, LVMI and AS were found to be predictors for systolic longitudinal strain. Body mass index, triglyceride, left ventricular ejection fraction, age, left ventricular mass index and pulse pressure/stroke volume were negatively related to systolic longitudinal strain (r=-0.10, -0.09, -0.14, -0.42, -0.56, all P<0.05) by Pearson′s correlation, while LVEF was positively related to mean systolic longitudinal strain (r=0.13, P<0.05).

Conclusion

Arterial stiffness is suitable as an predictor for left ventricular systolic deformation in hypertensive disease.

Key words: Arterial stiffness, Echocardiography, three-dimensinal, Ventricular function, left, Hypertension

Huihui Wu, Pin Sun, Zhibin Wang, Yong Li, Yan Li, Xiuxiu Fu, Junfang Li. Relationship between arterial stiffness and systolic deformation in patients with hypertension[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(12): 923-928.

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References 17

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组别	例数	年龄（岁，±s）	性别（例，男性/女性）	BSA（m²，±s）	心率（次/min，±s）	收缩压（mmHg，±s）	舒张压（mmHg，±s）
健康对照组	30	51±6	18/12	1.86±0.27	69±8	120±12^a	77±12^b
高血压LVN组	25	52±7	13/12	1.89±0.23	70±6	148±13	86±17
高血压LVH组	35	53±7	19/16	1.90±0.26	70±8	154±11	89±13
F值	?	0.21	0.39	0.21	0.18	71.77	6.30
P值	?	>0.05	>0.05	>0.05	>0.05	<0.01	<0.01

组别	例数	年龄（岁，±s）	性别（例，男性/女性）	BSA（m²，±s）	心率（次/min，±s）	收缩压（mmHg，±s）	舒张压（mmHg，±s）
健康对照组	30	51±6	18/12	1.86±0.27	69±8	120±12^a	77±12^b
高血压LVN组	25	52±7	13/12	1.89±0.23	70±6	148±13	86±17
高血压LVH组	35	53±7	19/16	1.90±0.26	70±8	154±11	89±13
F值	?	0.21	0.39	0.21	0.18	71.77	6.30
P值	?	>0.05	>0.05	>0.05	>0.05	<0.01	<0.01

组别	例数	IVST（cm）	LVIDd（cm）	LVPWT（cm）	LVMI（g/m²）	RWT	E/A	LVEF（%）	每搏量（ml）
健康对照组	30	0.93±0.10	4.41±0.18	0.88±0.13	94.02±7.8	0.39±0.09	1.21±0.24	67.52±4.3	38±6
高血压LVN组	25	0.98±0.14	4.56±0.62	0.94±0.18	98.6±9.8	0.42±0.03	1.12±0.19	66.82±3.8	41±5
高血压LVH组	35	1.25±0.75^a	4.60±0.19	1.20±0.32^b	130.12±9.3^c	0.48±0.05^d	0.79±0.07^e	68.64±5.2	39±6
F值	?	4.21	2.38	17.24	155.37	17.45	39.28	0.72	1.90
P值	?	<0.05	>0.05	<0.01	<0.01	<0.01	<0.01	>0.05	>0.05

组别	例数	IVST（cm）	LVIDd（cm）	LVPWT（cm）	LVMI（g/m²）	RWT	E/A	LVEF（%）	每搏量（ml）
健康对照组	30	0.93±0.10	4.41±0.18	0.88±0.13	94.02±7.8	0.39±0.09	1.21±0.24	67.52±4.3	38±6
高血压LVN组	25	0.98±0.14	4.56±0.62	0.94±0.18	98.6±9.8	0.42±0.03	1.12±0.19	66.82±3.8	41±5
高血压LVH组	35	1.25±0.75^a	4.60±0.19	1.20±0.32^b	130.12±9.3^c	0.48±0.05^d	0.79±0.07^e	68.64±5.2	39±6
F值	?	4.21	2.38	17.24	155.37	17.45	39.28	0.72	1.90
P值	?	<0.05	>0.05	<0.01	<0.01	<0.01	<0.01	>0.05	>0.05

分组	例数	脉压/每搏量（mmHg·m²/ml）	左心室收缩期峰值应变（%）			左心室收缩期峰值应变率（s^-1）
分组	例数	脉压/每搏量（mmHg·m²/ml）	纵向	径向	环向	纵向	径向	环向
健康对照组	30	1.26±0.45	23.60±1.94	28.69±5.21	24.50±5.21	1.64±0.17		2.51±0.56	1.38±0.38
高血压LVN组	25	1.53±0.59^a	19.69±2.56^c	30.81±4.14	24.01±4.60	1.52±0.14^g		2.60±0.45	1.30±0.30
高血压LVH组	35	1.82±0.43^b	17.34±2.48^d	26.53±3.50^e	21.00±3.70^f	1.38±0.18^h		2.00±0.41ⁱ	1.10±0.26^j
F值	?	10.78	58.39	7.27	5.76	19.84		14.60	6.83
P值	?	<0.01	<0.01	<0.01	<0.01	<0.01		<0.01	<0.01

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