Assessment Of Left And Right Ventricular Function In Essential Hypertension With Left Ventricular Different Geometric Patterns By Echocardiography

Objective:To explore the change of echocardiography in assessment of left and right ventricular function in essential hypertension with left ventricular different geometric patterns,and the relationship between the function change with the left ventricular different geometric patterns.Methods:Ninety-four hospital patients with essential hypertension were select at random.According to Ganau categories,these patients were divided into four groups as follows:normal left ventricle(groupⅠ,15cases),concentricremodeling(groupⅡ,17 cases),concentric hypertrophy(groupⅢ,48cases)and eccentric hypertrophy(groupⅣ,14cases),and 30 age-matched healthy subjects as contral group were included。The end-diastolic diameters of left ventricle(LVEDD),interventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass(LVM),left ventricular mass index(LVMI),relative wall thickness(RWT),E/A ratio(E/A)at septal and tricuspid orifice were measured.Ea/Aa ratio(Ea/Aa)and Sa at posterior mitralis annulus and anterior tricuspid annulus by Doppler Tissue Imaging were detected.Also,left and right ventricular ejection fraction(EF)were measured.The interval between cessation and onset of the mitral valve and tricuspid valve inflow measured from the mitral and tricuspid inflow velocity profile with pulsed-wave Doppler echocardiography is al.The interval b1 is ejection time which is measured from the aortic and pulmonary Doppler signal.a1-b1 is the sum of cardiac ventricle isovolumtric contraction time and isovolumetric,elaxation time.The pulse Doppler Tei index is calculated as(a1-b1)/b1.The interval between cessation of late diastolic wave Aa to onset of the next early diastolic wave Ea is a2.The interval between onset to cessation of the wave Sa is b2.a2-b2 is the sum of right ventricular isovolumetric contraction time and isovolumetric relaxation time. The Tissue Doppler Tei index is calculated as(a2-b2)/b2.Results:①the ninety-four hospital patients with essential hypertension,the ratio of concentric hypertrophy is the most(51%).②Compared with control group,E/A and Ea/Aa in four groups were lower than that of the normal.The detection rate of Ea/Aa is higher than The detection rate of E/A.③EF and Sa only was greatly decreased inⅣgroup. ④Left ventricular pulse wave Doppler Tei indices and tissue Doppler Tei indices of all groups were increased than that of the normal (0.29±0.05/0.30±0.03,0.39±0.04/0.40±0.04,0.43±0.06/0.45±0.06, 0.53±0.14/0.59±0.06,0.71±0.28/0.76±0.28,P＜0.05).There was significant difference between groupⅢ,ⅣandⅠ,Ⅱ,as well as between GroupsⅣandⅢin left ventricular Tel index(P＜0.05).The pulse wave Doppler Tei index was positively correlated with the tissue Doppler Tei index(r=0.77,P＜0.01).The two methods have significant difference.⑤Right ventricular pulse wave Doppler Tei indices and tissue Doppler Tei indices of groupsⅡ,Ⅲ,Ⅳwere increased than that of the normal (0.28±0.06/0.31±0.06,0.35±0.12/0.41±0.10,0.38±0.12/0.48±0.12, 0.57±0.25/0.62±0.29,P＜0.05).There was significant difference between groupⅣandⅠ,Ⅱ,Ⅲ(P＜0.05).The pulse wave Doppler Tei index was positively correlated with the tissue Doppler Tei index(r=0.69,P＜0.01).The two methods have significant difference.⑥Left and right ventricular pulse wave Doppler Tei index was negatively correlated with EF and E/A(r=-0.34/-0.24,-0.52/-0.24,P＜0.01).Left and right ventricular tissue Doppler Tei index was negatively correlated with Sa and Ea/Aa(r=-0.21/-0.21,r=-0.40/-0.20,P＜0.05).⑦Right ventricular E/A,Ea/Aa,pulse wave Doppler Tei index and tissue Doppler Tei index was positively correlated with that of the left ventricular respectively(r=0.40,0.38,0.30,P＜0.01 and 0.23,P＜0.05). Conclusions:①the ninety-four hospital patients with essential hypertension, the ratio of concentric hypertrophy is the most.②Left and right ventricular function in hypertension changed.③The impairment degree of function was different in different patterns,among of them concentric hypertrophy and eccentric hypertrophy had the serious impairment.Global function of left ventricular was decreased in the early stage.④Left and right ventricular function influence each other.That left ventricllar Tei index increased earlier than that of right ventricular hinted left ventricular global function changed earlier than right ventricular。⑤Tei index was valuable and easy for estimating left and right ventricular systolic and diastolic functions with high sensitivity.⑥pulse wave Doppler Tei index and tissue Doppler Tei index were bothe useful.