Correlation Study Between Carotid Atherosclerosis And Left Ventricular Remodeling By Echo Tracking Technique In Primary Hypertension Patients

BackgroundWith the change of people’s diet structure and the accelerated pace of life, primary hypertension patients is increasing year by year.Hypertension has become the primary cause of the death of cardiovascular and cerebrovascular disease,which is closely related to target organ damage and severe complication. Hypertension can directly lead to vascular remodeling and cardiac hypertrophy named as cardiac and vascular remodeling, which is also the independent risk factor of cardiovascular disease. Carotid artery because of its special location and function characteristics has become a routine testing site to measure systemic arteriosclerosis.The EF(E-tracking) can early provides more accurate reference information for clinic such as quantitative indicators of arterial wall elasticity. More and more clinical experts pay attention to ET.At present, there are many studies on the correlation between carotid artery intima-middle thickness (IMT), atherosclerotic plaque and left ventricular remodeling in patients with primary hypertension. The study of the correlation between the degree of carotid atherosclerosis and left ventricular remodeling in patients with primary hypertension using echo tracking technique with multi parameter is rarely reported.ObjectiveTo investigate the correlation between early carotid artery atherosclerosis and left ventricular remodeling in primary hypertension patients using the echo tracking technique.Materials and Methods1.Patient sample100 patients with primary hypertension in cardiac department from July 2013 to July 2014 were enrolled in this study, including male 57 cases, female 43 cases. The average age of the patient sample were (58±3.5) years, ranging from 36 to 78 years old. All patients had been diagnosed by echocardiography and carotid artery high frequency ultrasonic examination, and the formation of carotid atherosclerotic plaque was excluded.100 patients were divided into two groups based on LVMI: patients with left ventricular hypertrophy(LVH groups,34 cases) and patients without left ventricular hypertrophy(NLVH groups,66 cases).2.Instrument and Examination2.1 EchocardiographyPatients were scanned on a PHILIPS iE33 sonography system with a S5-1 phased array probe.Echocardiography was performed. Left ventricular end-systolic diameter (LVEDs), left ventricular end-diastolic diameter (LVEDd),left ventricular posterior wall thickness (LVPW) and interventricular septum thickness (IVS) were measured and left ventricular mass index(LVMI) was calculated.Body surface area (BSA) was calculated according to Stevenson formula.2.2 ETPatients were scanned on a ALOKA a-10 sonography system with a high freqency linear array probe.Echo tracking imagines were performed to evaluate the carotid arteriosclerosis of the patients and the following parameters were measured: coefficient of elastic (Ep), stiffness ((3), compliance (AC), enlargement coefficient (AI), pulse wave conduction velocity (PWVβ).2.3 Correlation analysisCorrelation analyses between LVMI and Ep, β, AC were performed.3. Statistical analysisStatistical analyses were performed using SPSS 19 software.All measurement data were expressed as x ± s. Independent sample t test was used for comparisons. Pearson correlation analysis was used between LVMI and Ep, β, AC. A P value< 0.05 was considerde satistically significant.Results1. The comparison of general information between the two groupsThere was no significant difference in age between the two groups (P>0.05). There were significant differences in systolic pressure, diastolic pressure, pulse pressure and duration between the two groups (P<0.01).2. The comparison of echocardiography parameters between the two groupsThere were significant differences in LVEDs, LVEDd, LVPW, IVS and LVMI between the two groups (P<0.01,P<0.05).3. The comparison of p, Ep, AC,AI and PWV β between the two groupsThere were significant differences in β, Ep, AC,AI and PWV β between the two groups(P<0.01).4. Correlation analyses between LVMI and Ep, P, ACThere was a significant positive correlation between LVMI and β, Ep(r=0.782,0.726,P<0.001), but a negative correlation with AC (-0.742, P< 0.001).Conclusions1. Left ventricular remodeling and vascular remodeling in patients with primary hypertension are parallel.2. The left ventricular mass index (LVMI) in patients with primary hypertension and carotid arterial stiffness (β), pressure strain elastic modulus (Ep), compliance (AC) have a significant correlation.3. The artery elastic parameters obtained by echo tracking technology can evaluate the degree of arterial damage in patients with primary hypertension, which will help to guide clinic to assess the cardiovascular risk earlier.