Assess Ment Of Right Ventricular Diastolic Funclionin Patients With Essential Hypertension And Insulin Resisitance By Pulsed-wave Tissue Doppler Imaging

Objective:As a usual illness, hypertension is one of the main causes of death of cardiovascular diseases.It can be divided into essential hypertension and secondary hypertension.Hypertension and insulin resisitance are important parts of metabolic syndrome.In this researh we want to explore whether there is any interaction between essential hypertension and insulin resisitance in the result of changes of right ventricular diastolic funclion by pulsed tissue doppler imaging.Methods: All of the134subjects were collected in Physical examination Center and internal medicine department outpatients from Taigang General Hospital,mean age48.24±6.16.There were68men and66wemen in the research.We used2×2factorial design in the research.The two influencing factors refer to essential hypertension and insulin resisitance.From March2011to January2012, we studied35healthy subjects as control group,31subjects with insulin resisitance but without essential hypertension,36subjects with essential hypertension but without insulin resisitance,32subjects with essential hypertension and insulin resisitance,age ranging from thirty-six to sixty years.We collected the datas of blood pressure, fasting blood glucose, fasting insulin,height,weight. We estimated insulin resistance by the homeostasis model assessment (HOMA-IR),and we also acquired the body mass index with the datas of height and weight. Under2-dimensional Echo image of corrected4-chamber view, pulsed-wave tissue doppler imaging were applied to measure the paraments just as peak early diastolic annular velocity(Em), peak diastolic annular velocity with atrial contraction(Am), isovolumic relaxation time (IVRT),and we also calculated the ratio of Em/Am. Under the same view, pulsed-wave doppler imaging were applied to measure the parament of peak early diastolic velocity(E), and the ratio of E/Em were also calculated.Results: Among all of the subjects with essential hypertension but without insulin resisitance,subjects with essential hypertension and insulin resisitance,subjects with insulin resisitance and the healthy controls, there was no significant differences in gender,age,weight,height and variation of heartrateObserving indexes:1Em The interaction between the two factors ofessential hypertension and insulin resisitance was not statistically significantF0.213P0.645.2Am: The main effects of the factor of insulinresisitance was not statistically significant(F0.237P0.627Theinteraction between the two factors of essential hypertension and insulinresisitance was not statistically significant F2.111P0.149.3Em/AmThe interaction between the two factors of essential hypertension and insulinresisitance was not statistically significant F2.894P0.091.4IVRTThe interaction between the two factors of essential hypertension and insulinresisitance was statistically significant. IVRT of subjects with essentialhypertension and insulin resisitance was longer than the healthy controlssubjects with insulin resisitance but without essential hypertension subjectswith essential hypertension but without insulin resisitance F52.234P0.001.5E The interaction between the two factors of essential hypertensionand insulin resisitance was not statistically significant F0.001P0.975.6E/Em The interaction between the two factors of essential hypertensionand insulin resisitance was not statistically significant F2.863P0.093.Conclusion Insulin resisitance can induce right ventricular diastolicdisfunclion. Essential hypertension can induce right ventricular diastolicdisfunclion. There was no significant interaction between the two factors ofessential hypertension and insulin resisitance in this research.