| [Objective] This study was designed to analysis features of coronary artery disease and left ventricular function in patients with essential hypertension by 64-slice spiral CT,and to compare differences of groups with different blood pressure levels. It can provide a basis for the comprehensive treatment of clinical hypertension.[Methods] 105 cases of EH selected according to the WHO diagnostic criteria.They were divided into three groups:1,2 and 3 level group according to the level of blood pressure.The normal control group included 35 cases.All cases underwent 64-slice spiral CT cardiac imaging scanning,were analyzed the characteristics of coronary lesions, and were computed the parameters including left ventricular ejection fraction(LVEF), left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular stroke volume(LVSV),cardiac output(CO), cardiac index(C1)and left ventricular myocardial mass(LVMM)by functional analysis package. All the data were analysed by SPSS 10.0 software, I analysed the relationship of coronary artery disease and left ventricular function with blood pressure,and compared differences of coronary artery disease and left ventricular function of different blood pressure groups.[Results] 1. Proportionality test:The three groups of hypertension compared with control group and three groups of hypertensive pairwise comparison,male and female sex ratio, age, duration and smoking had no statistically significant difference (P> 0.05). It is the most obvious that hypertension combined with hyperlipidemia in grade 3 hypertension group. Hyperlipidemia of grade 3 hypertension group and the control group, grade 1 hypertension group had statistically significant difference (P<0.05). Grade 1,2 hypertension group compared with control group and grade 2 hypertension group compared with grade 3 hypertension group, they had no statistically significant difference (P> 0.05). Body mass index of grade 3 hypertension group higher than control group, grade 2 hypertension group,it had statistical difference (P<0.05). Body mass index of grade 1,2 hypertension group and control group had no statistically significant difference(P> 0.05). Grade 1 hypertension group compared with grade 2,3 hypertension groups showed no difference (P> 0.05) (Table 1).2. Hypertension and coronary artery disease:High blood pressure levels are associated with coronary artery disease by testing.The normal rate of coronary arteries in different level hypertensive groups was significantly lower than those in the control group, they were significantly different (P<0.01). Among the three hypertensive groups,the normal rate of coronary artery in grade 3 hypertension group is the lowest by comparison (14.3%). But they showed no significant difference by comparing with grade 1,2 hypertension group (P> 0.05). Mild coronary artery disease in each group had no significant differences between (P> 0.05). Normal, single branches, double branches and three branches lesions are significantly different among the four groups (P<0.05). The patients with double branches and three branches lesions in grade 3 hypertension group was more than in the control group and grade 1 hypertension group, they were statistically significantly different (P<0.05). Coronary artery disease of patients in grade 1 hypertension group consists mainly of normal, mild, single-branch disease (Table 2).3. High blood pressure levels and cardiac function:(1) LVEF:LVEF of patients in grade 3 hypertension group was significantly lower than in grade 1,2 hypertensive groups and the control group, they were statistically significantly different (both P<0.01). There were no significant difference in grade 1,2 hypertension group and the control group by pairwise comparing (P> 0.05). (2) LVEDV:LVEDV of patients in grade 3 hypertension group was more significantly increased than in the control group,grade 1,2 hypertension groups, there are statistically significant differences (P<0.01). LVEDV of patients in grade 1,2 hypertension group is larger than in the control group, but there were no difference (P> 0.05). Among hypertension groups comparing, LVEDV increased with the blood pressure levels increasing. But in two groups of grade 1,2 hypertension, it showed no significant difference(P> 0.05). (3) LVESV: LVESV of patients in grade 3 hypertension group was more significantly increased than in the control group,grade 1,2 hypertension groups, there were statistically significant differences (P <0.01). LVESV of patients in grade 1 hypertension group was slightly lower than the control group, but there was no statistically significant difference (P> 0.05). LVESV of patients in grade 2 hypertension group is larger than in the control group and grade 1 hypertension group, but there were no significant difference (P> 0.05).Among three hypertension groups comparing, LVESV increased with the increase of blood pressure levels. (4) LVMM:Each LVMM in three hypertension groups significantly increased by comparing with the control group.There were significant differences (P<0.05). LVMM Of grade 1,2 hypertension groups showed no difference (P>0.05).Grade 3 hypertension group compared with grade 1,2 hypertension,LVMM of patients in grade 3 hypertension group was significantly increased,and they are different (P <0.05). (5) LVSV,CO:LVSV,COof three hypertension groups and control group there were no significant differences by pairwise comparing (P> 0.05), although LVSV,CO lowered with the elevated levels of blood pressure. CI:Grade 3 hypertension group was compared with the other groups,CI is more significantly reduced.it is significantly different between the groups (P<0.05). CI of patients in grade 1,2 hypertension groups and the control group had no significant difference by pairwise comparing (P> 0.05) (Table 3).4. Logistic regression multivariate analysis of influence of coronary artery disease: Blood pressure,BMI and age is a risk factor for coronary artery disease. By testing blood pressure and coronary artery disease is the most relevant.[Conclusion] (1) With the elevated levels of blood pressure, coronary artery disease is increased. Two-branches and three-branches lesions are main lesions in grade 2,3 hypertension. Blood pressure,BMI and age are related with coronary artery disease.The blood pressure is the most relevant. (2) Left ventricular pump function is subsided with the elevated levels of blood pressure. Grade 1,2 hypertension occurred hypertrophy, no change in cardiac function, grade 3 hypertension occurred significantly hypertrophy,cavity expansion and cardiac function decreased significantly. (3) 64-slice CT can serve as the clinical screening method of suspected coronary heart disease in patients with hypertension, can serve as a new method for evaluation of cardiac function. |
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