The Study On Evaluation Of The Carotid Elasticity In Patients With Hypertension Using Two-dimensional Strain Imaging

Objective:To test carotid artery elasticity in hypertensive patients using two-dimensional strain imaing and M mode echocardiogram, explore the relationship between the arter y elasticity and blood pressure, the superiority and clinical application value of the two-dimensional strain imaing in evaluating artery elasticity.Methods:One hundred and sixty patients were enrolled in the researsh, excluding of secondary heypertion,coronary heart disease, diabetes and cardiomyopathy.They were divided into normal control group, hypertension level1, hypertension level2. and hypertension level3. Record the patient’s age, gender, height, weight, history of hypertension, smoking history, drinking history in general; The biochemical makers include uric acid(UA), creatinine(Cr),blood urea nitrogen(BUN), fasting blood glu eose(FBG), cholesterol(TC). triglyceride(TG). low density lipoprotein(LDLc).Record the echocardiographic parameters like left ventricular end-diastolic diameter(LVDd). left ventricular end systolic diameter(LVDs). interventricular septal thickness (IVST). left ventricular posterior wall thickness(PWT), left ventricular ejection fraction(LVEF) and mitral inflow E/A ratio and calculate left ventricular mass(LVM), left ventricular mass index(LVMI):All the patients are detected carotid ultrsound, detailed records of parameters include:carotid intima-media thickness (IMT), carotid artery systolic diameter(Ds). carotid artery diastolic diameter(Dd). peak systolic velocity (PSV), end-diastolic velocity(EDV). pulsatility index(PI) and resistance in dex(RI). We can obtain M-mode ultrasound vascular elasticity index like the vessel wall motility(△D), the stiffness parameter β1, pressure strain elastic modulus(Ep), arterial compliance (AC) by calculating; To measure the circumference of the short axis of the carotid artery peak global systolic strain(CS), early systolic global circumferential strain rate(CSr) and the late systolic global absolute value of circumferential strain rate by two-dimensional strain imaging techniques, and then calculate the stiffness parameter β2. Finally, all the obtained datas were statistically analyzed and processed. Results:1.There is no obvious difference between the hypertension groups and the con-trol group in serological index (p>0.05).2. In comparison of carotid ultrasound parameters, LVMI, IVST, PWT of HBP3are higher than them in HBP2, HBP1and normal control group, while the E/A ratio of HBP3is lower than the other groups (p<0.05).3. In comparison of M mode echocardiogram ultrasound parameters, the IMT, Ep, β1of HBP3are higher than them in HBP2, HBP1and normal control group; and△D, AC are lower than the other groups (p<0.05).4. In comparison of two-dimensional strain parameters, CS. early systolic CSr and the late systolic absolute value of CSr reduce gradually along with blood pressure elevating, but the β2increase gradually. While there is significant difference between HBP1and the normal control group.5. Pearson correlation analysis indicated that carotid artery△D, the systolic peakglobal CS. early systolic global CSr and the late systolic global absolute value of CSr are negatively corelated with LVMI, r are-0.167,-0.345and-0.299and-0.137, while Ep, stiffness parameter β1,β2are positively corelated with LVMI,r are0.312and0.262and0.163.6. Pearson correlation analysis indicated that the systolic peak global CS. early systolic global CSr and the late systolic global absolute value of CSr are positively related with E/A ratio.Conclusions:1.Hypertensive patients have changes in left ventricular structure and diastolic function, with blood pressure elevating. IVST. PWT and LVM1are aggravating.and diastolic function is declining gradually.2.IMT,Ep.β1in hypertension patients are higher than the normal control group and AC is lower than it. so that indicated there is abnormal artery elasticity in hyper-tension patients, along with elevated blood pressure, artery elasticity is decreased.3.Hypertension patients’CS. CSr decreased along with the blood pressure eleva- ting, while β2increased, so that indicated the stiffness is increasing as the blood press ure elevating.4. The systolic peak global CS. early systolic global CSr and the late systolic global absolute value of CSr,△D,Ep,β1,β2are corelated with LVMI obviously, so the carotid ultrasound parameters are good index to react the degree of damaged organs.5. There are obvious changes between HBP1and the normal control group in CS, CSr, P2, it indicates that two-dimensional strain imaging technology can test the early carotid artery elasticity change and become one of the early diagnostic methods.