Ultrasonic Characteristics Of Epicardial Adipose Tissue In Patients With H-type Hypertension

Objective:The thickness of epicardial adipose tissue(EAT)in different parts of patients with H-type hypertension was measured by echocardiography to explore the ultrasonic characteristics,related factors and influencing factors of EAT in patients with H-type hypertension.Methods:A total of 159 inpatients in our hospital were selected and divided into healthy control group(50 cases),non-H-type hypertension group(54 cases)and H-type hypertension group(55 cases)according to blood pressure and serum homocysteine(Hcy)level.There was no difference in age or gender between healthy control group and case group.Clinical data and laboratory data were collected for all participants,and echocardiography was performed to measure EAT thickness and conventional ultrasonic parameters at different locations.The general clinical data,conventional echocardiographic characteristics and EAT thickness were compared among groups,and the related factors and influencing factors of EAT thickness in patients with H type hypertension were analyzed.Results:1.There were no significant differences in gender,age,FBG,TC,TG,HDL-C and LDL-C among the three groups(P > 0.05).2.Compared with the control group,IVSD,LVMI,peak A flow velocity of mitral valve and left ventricular diastolic function abnormalities were increased in NH and HH groups,peak E flow velocity of mitral valve and the mitral annular velocity in early diastolic(e)were decreased,the difference was statistically significant(P < 0.05),left atrial anteroposterior diameter was increased,the LVEF were decreased in HH group,the difference was statistically significant(P < 0.05).Compared with NH group,LVMI,left ventricular diastolic function abnormalities and peak A flow velocity of mitral valve were increased in HH group,and LVEF was decreased,the difference was statistically significant(P < 0.05).There were no significant differences in LVEDd,LVPWD and E/A among the three groups(P > 0.05).3.Compared with the control group,EAT thickened at the anterior wall of the right ventricle,posterior wall of the left ventricle,apex of the heart,lateral wall of the left ventricle and lateral wall of the right ventricle in groups NH and HH,and the difference was statistically significant(P < 0.05).Compared with NH group,EAT thickened at all the above sites in HH group,and the difference was statistically significant(P < 0.05).4.The EAT thickness at the anterior wall of right ventricle was positively correlated with Hcy,SBP,DBP,BMI and LVMI(r=0.621,0.586,0.392,0.312,0.327 P < 0.05).The EAT thickness at the posterior wall of left ventricle was positively correlated with Hcy,SBP and BMI(r=0.417,0.270,0.271,P < 0.05).The EAT thickness at apex was positively correlated with Hcy,SBP and DBP(r=0.441,0.419,0.367,P < 0.05).The EAT thickness at the right ventricular lateral wall was positively correlated with Hcy,SBP and BMI(r=0.453,0.424,0.267,P < 0.05).The EAT at the left ventricular lateral wall was positively correlated with Hcy,SBP and DBP(r=0.468,0.446,0.439,P < 0.05).5.Hcy was the influence factor of EAT thickening at the anterior wall of right ventricle,posterior wall of left ventricle,apex of heart,lateral wall of right ventricle and lateral wall of left ventricle(sβ=0.661,0.345,0.376,0.421,0.507,P < 0.05).SBP was the influence factor of EAT thickening at the anterior wall of right ventricle and apex(sβ=0.344,0.374,P < 0.05).Conclusions:The EAT thickening in patients with H-type hypertension is more obvious than that in patients with non-H-type hypertension,and EAT thickening is related to hypertension and Hcy increase.Systolic blood pressure and hyperhomocysteinemia are the influencing factors of EAT thickening.Clinicians and sonographers should pay attention to EAT thickening in patients with H-type hypertension.