| PrefaceHypertension is one of the commonest cardiovascular diseases. The left ventricle ( LV) of hypertension patients is generally thought to adapt to sustained arterial hypertension by developing hypertrophy and remodeling. The prognosis is related to LV pattern and left ventricular mass index (LVMI) . The highest risk occurred in those with concentric hypertrophy and the lowest risk occurred in those with normal left ventricular geometry; the risk was intermediate for patients with concentric remodeling and eccentric hypertrophy. To prevent and improve ventricular remodeling was an important target.Although conventional echocardiography is particularly useful in providing fundamental information about heart structure, morphology and function by observing the size of heart chambers and the thickness, echo level or moving of LV wall, it cant evaluate myocardial pathologic changes. Ultrasonic myocardial integrated backscatter technology can detect physical and pathologic changes of myocardial tissue according to myocardial tissue acoustic characterization. Ultrasonic tissue characterization consists of the identification of the abnormalities in the physical or physiological state of biological structures based on analyzing interactions between ultrasound and tissue. In this study weevaluate the clinical application of ultrasonic backscatter parameters to assessment of the lesion of myocardium in patients with hypertension by different LV remodeling.MaterialsDate were obtained from 146 patients (males 95,females 51 ,age 51. 6 ± 12.3 years) with essential hypertension. Hypertensive patients had systolic blood pressure ( BP) > 160 mmHg or diastolic BP ^ 95 mmHg. Patients were divided into four groups, according to the values of LVMI and relative wall thickness ( RWT) : Normal LV( group 1) , concentric remodeling ( group 2 ) , concentric hypertrophy ( group 3 ) and eccentric hypertrophy ( group 4). A control group of 32 normal subjects (males 22,females 10,age 52. 2 ± 10. 3 years) who had BP < 140/90 mmHg was also studied.For all patients, echocardiography measures were performed with the instrument of Hewlett-Packard Sonos-5500 with IBS analysis software with a 2 ~ 4 MHz phased array transducer.MethodsTwb-dimensional images were obtained in the parasternal left ventricle long-axis views in both patients and control subjects. Left ventricular end-diastolic diameters (LVID) and wall thickness were measured. Left ventricular mass(LVM) and LVMI were calculated by the Pennfc formula.Integrated backscatter system preset and data acquisition; Switching on AD-IBS procedure, we preset the instrument settings of gain,depth, LGC and TGC. We respectively acquired digital integrated backscatter (IBS) image sequences of the ventricular septum and the LV posterior wall from the parasternal long-axis view.Statistical analysis. All data presented as mean value ± SD. Data acquired was analyzed by EXCELL 2000 and SPSS 8.0 software.Results1. Clinical and echocardiographic characteristics of normal and hypertensive subjects. There were no statistical differences in age, gender, body surface area or body mass index between hypertensive and normal subjects either in the entire study group. Compared with the normal subjects, hypertensive patients had significantly higher systolic and diastolic blood pressure, LV wall thickness, LVM and LVMI.2. Patterns of left ventricular geometry. Of the 146 hypertensive patients,64 were in group 1,18 were in group 2,20 were in group 3 and 44 were in group 4. While LVMI was the highest in group 3 (176.13 ±75. 00 g/m2) and also high in group 4 (156.41 ±44.15 g/ m2) and group 2 (103. 07 ± 10. 80 g/m2). RWT was the highest in group 3(0.53 ±0.08) and also high in group 2(0.48 ±0.04 ) (P < 0.01). LVID was the highest in group 4(5.76 ±0.50 cm) and also high in group 3(5. 01 ±0.71cm) (P<0.01). Total peripheral resistance was the highest in group 2(4.68 ±0. 60 kPa ?s/1) and high in group 3 (4. 23 ±1. 36 kPa ?s/1) and group 1 (4...
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