| Essential hypertension (EH) is a common disease in old and elderly people. The main risk in EH is arteriosclerosis and its complications in heart, brain and kidney. It has demonstrated that the endothelium and its dysfunction in arteries has plays an important role in the appearance and development of EH and its complications, which is the initial change of arteriosclerosis. So it was suggested that endothelial dysfunction was the early appearance of the arteries in EH. The aim of the first part of this study was to evaluate the influence of brachial artery endothelial function in early hypertension by inflation test using high-frequency ultrasound. ? E-tracking technique is a newly developed ultrasound-based technique of late years, which can dynamic trace the track of artery endothelium and calculate the change of the arterial diameter. It provides a new method to evaluate the arterial distensibility with its high resolution. The second part of this study was to assess the distensibility of carotid and brachial artery between normal subjects and patients with early essential hypertension.Part 1 Evaluation of brachial artery endothelial function in patients with early essential hypertension by ultrasound techniqueMethod1. The study population included 38 subjects with 1 stage hypertension, 22 subjects with 2 stage hypertension and 47 matched healthy subjects. The EH diagnosis are according to 1999 WHO/ISH criterion. There was no significant difference of clinic information in three groups except blood pressure..2. All subjects were performed echocardiography. IVST, LVEDd, LVPW, LVEDs, AO, LA, PVE, PVA, DT and IVRT were obtaineddirectly, from which FS,EF,SV,LVM,LVMI and PVE/PVA were calculated.3. LCCA and RCCA were examined using high-frequency linear probe. IMT, D, Vmax, Vmean, Vmin, RI, PI and IMT/D were obtained.4. The IMT, D1, D0, and V1 were measured in the basal state. D2 and V2 were obtained in reactive hyperaemia. FMD, PVI, AD, RD , DC, and CC were calculated.Result1. PVE, and PVE/PVA in hypertensive people were significantly lower than those in control subjects, whereas PVA and IVRT were significantly higher than those in control subjects. There was no significant difference of other heart parameters (LA, AO, IVST , LVEDd, LVEDs, LVPW, FS, SV, EF, DT) in three groups. And there was no significant difference of heart parameters in two hypertension groups.2. There was no significant difference of carotid parameters (Ds, IMT, IMT/DK Vmax, Vmin, Vmean, PL RI) in three groups.3. There was no significant difference of brachial arterial structure (Ds, Dd, IMT, IMT/Ds) and doppler parameters (V], V2) in three groups. Flow-mediated dilatation (FMD) and peak velocity improve (PVI) were decreased in essential hypertension groups compared with those of control (Pfrt 13.79±2.69 vs. 20.10±4.69, 12.27±4.14 vs. 20.10±4.69, p<0.05; FJV\D5.17±1.85 vs. 8.16±2.77, 5.11±1.69 vs. 8.16±2.77, p<0.05). CC in hypertensive people was significantly lower than that in control subject ( CC 0.07±0.03 vs. 0.10±0.04, 0.06±0.03 vs. 0.10±0.04, p<0.05). There was no significant difference in two hypertension groups.ConeIus i onArtery endothelial function was damaged during early hypertension, when the arteriosclerosis of the common carotid artery and brachial artery were rarely found. This demonstrated that the damage of the artery distensibility was earlier than arteriosclerosis. The change of artery distensibility was sensitive index to reflect endothelial function whichwould have important value in clinic.Part 2 Quantitative evaluations of carotid and brachial arterydistensibility in patients with early essential hypertension by e-tracking techniqueMethodsWe measured the parameters of the left ventricular structure and function by echocardiography in 21 normal subjects (age 54.29±9.67y) and 20 patients(57.05±7.73y) with early essential hypertension. With the high resolution ultrasound, the Ds, Dd, IMT and RI of carotid and brachial artery were measured, the diameter change... |
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