Myocardial Work Was Performed To Evaluate Different Left Ventricular Configurations Clinical Study Of Left Ventricular Function In Patients With Hypertension

Background:Hypertension(HP)is a clinical syndrome characterized by a continuous increase in systemic arterial pressure.Some scholars study shows that the incidence of cardiovascular disease and the correlation between the level of blood pressure is high,a long period of high blood pressure can make the left ventricular myocardial reconstruction,Based on left ventricular mass index(LVMI)and relative wall thickness(RWT),Ganau divided the left ventricular geometry of hypertension patients into four groups,the prognosis of patients with left ventricular configuration change there is relationship between.Different cardiac segmental deformability can be analyzed by strain and strain rate,which can comprehensively evaluate the abnormal global or local function of the myocardium,but it is load-dependent.When the afterload is increased,the strain of the myocardium will decrease,resulting in the false decrease of myocardial systolic function.In recent years,quantitative analysis of myocardial function has been a hot topic at home and abroad.The pressure strain loop(PSL)technique combines the two dimensional speckle tracking techniques with pressure load to effectively reduce load dependence and quantitatively analyze segmental or global cardiac work.OBJECTIVE:In this study,the pressure strain loop technique was applied to evaluate the changes of left ventricular function in hypertensive patients with different left ventricular configurations,in order to provide relevant evidence for the clinical evaluation of cardiac remodeling in hypertensive patients.Methods:90 with hypertension diagnosed in our hospital were selected and divided into 4groups according to Ganau classification method and Chinese critical value,namely normal configuration group(NG group),centripetal remodeling group(CR group),centripetal hypertrophy group(CH group)and eccentric hypertrophy group(EH group).The control group included 30 healthy subjects during the same period.To them after the conventional echocardiographic measurement,collect four cavity heart apex,apex three cavity,apex two cavity the hearts of a dynamic image of 3 ～ 5cardiac cycle,Echo PAC workstation was used to analysis,measurement and record of the following data from the workstation: global longitudinal strain(GLS),peak strain dispersion(PSD),global construction work(GCW),global waste work(GWW),global work efficiency(GWE)and global work index(GWI),statistical analysis of the data was performed using SPSS 24.0,with P < 0.05 for statistically difference.Results:GLS decreased gradually from N to EH group,and there was statistical difference between hypertension group and control group(P < 0.05).Compared with the control group,the PSD of the hypertension group was increased,and the difference was statistically significant(P < 0.05),and there were significant differences between NG group,CH group and EH group.GWI and GCW in the hypertension group were higher than those in the control group,and there were significant differences between the NG group and the control group(P < 0.05).GWW in the hypertension group was higher than that in the control group,and the difference was statistically significant(P < 0.05).GWE showed a downward trend,and there were significant statistical differences between NG group and CR group,CH group and EH group and control group(P < 0.05).CONCLUSIONS:1.Before the decrease of left ventricular ejection fraction,the left ventricular longitudinal strain had been reduced in hypertension patients,indicating that the left ventricular longitudinal strain was susceptible to pressure load.2.Hypertensive myocardial contraction is out of synchrony,accompanied by changes in left ventricular configuration gradually aggravated.3.The global construction work of myocardium increased when left ventricular configuration was not changed in hypertension.4.When the left ventricular configuration is normal in hypertension,the global waste work of the myocardium has increased.With the change of the left ventricular configuration,the global waste work of the myocardium has increased significantly,and the global work efficiency has decreased significantly.