Correlation Of Hypertensive Cardiovascular Risk Stratification And Left Ventricular Diastolic Dysfunction And NT-proBNP

Objective:To evaluate the correlation between hypertensive cardiovascular risk stratification and left ventricular diastolic dysfunction and NT-proBNPBackground:Hypertension is a major public health problem around the world. If we do not actively prevent hypertension, it will cause damage to our heart, brain, kidney, eye, carotid, lower limb arteries, so as. to cause serious harm to human health complications. Hypertension is known as an important risk factor for cardiovascular disease, high blood pressure can lead to left ventricular hypertrophy, and it is an important cause of contraction and diastolic heart failure. In the past few decades, we focused mostly on the left ventricular systolic dysfunction which is confirmed by the echocardiography that heart failure with reduced ejection fraction, so now we have made great progress for systolic heart failure in all aspects of knowledge and understanding. In contrast, left ventricular diastolic dysfunction, but we do not receive proper attention, left ventricular diastolic dysfunction to heart failure accounts for nearly50%, and have a higher morbidity and mortality.Subjects and Methods1. To Selecte151hypertensive patients inpatient or outpatient from December2012to January2014of Dong E People’s Hospital, male61cases, female61cases. The youngest45years old, maximum83years. To cardiovascular risk stratification According to the2010Chinese Hypertension Prevention Guideline [70],27patients were divided into low-risk, intermediate-risk group of29patients,30patients at high risk, very high-risk group of36patients. All patients met the diagnostic criteria of hypertension which comes from Chinese Hypertension Prevention Guideline. Separate control group of29healthy people.2^All selected candidates admitted echocardiography in the elbow while taking blood3ml, adding anticoagulant tube mix should ROCHE COBAS E601automatic electrochemiluminescence immunoassay analyzer NT-proBNP.Were carried out on151cases selected echocardiography to assess left ventricular diastolic function:all included in the study patients received routine ultrasound examination (including a two-dimensional ultrasound and color Doppler ultrasound) and tissue Doppler examination, with the two-dimensional ultrasound In the left ventricular long axis, in the left ventricular end-diastolic (when the left ventricular wall thinnest) to measure septal thickness, left ventricular end-diastolic diameter, left ventricular posterior wall, left ventricular end-systolic diameter, left ventricular ejection fraction was calculated according to the formula and left ventricular mass, and then selected by the calculation based on height and weight to body surface area thus calculated left ventricular mass index; apical four-chamber view in the sampling line placed in mitral tip level, pulsed Doppler mitral valve flow spectrum, measuring peak early diastolic mitral flow velocity (E) and late diastolic mitral peak flow velocity (A). Application of tissue Doppler mitral annulus record (septal side) movement spectrum measurements early diastolic mitral annular velocity (E’), there are these indicators calculated E/A, E/E’, measuring isometric The above figures are the average of three consecutive cardiac cycles; relaxation time. All values were taken by two double-blind, fixed ultrasound the doctor after the operation proceeds averages. The combination of the above parameters were selected for hypertension Comparative analysis of cardiovascular risk stratification with different groups, comparing the healthy control group, high blood pressure low risk, medium risk and high risk, very high risk of changes in NT-proBNP between different groups, different groups measured by analysis of left ventricular diastolic function parameters with NT-proBNP.3、All data were analyzed using statistical software SPSS16.0, targets not normally distributed, the median describes the application of central tendency for each group and plotted, application of multi-sample nonparametric test Kruskal Wallis Test, using the Spearman rank correlation analysis inspection Act, P<0.05was considered statistically significant.Results:The normal control group with various cardiovascular risk stratification in hypertension:DCT (ms) the difference between the groups was not significant statistically significant, LVMI (g/m), E/A, E/E’, IVRT (ms), differences in NT-proBNP (pg/ml) there was significant statistical significance, which, LVMI (g/m), E/E’, IVRT (ms), NT-proBNP (pg/ml) from normal control group, hypertension cardiovascular risk stratification of low-risk group, risk group, high-risk groups to the very high risk group showed an increasing trend, E/A showed a decreasing trend. LVMI, E/E’of the low-risk group and the normal group there was a significant difference statistically significant (p values were0.017,0.030). In addition LVMI and IVRT, DCT and IVRT wireless-related, but each has a linear correlation between the other indicators. Which the E/E’ with NT-proBNP strongest correlation (correlation coefficient0.729, P value less than0.01), LVMI, E/A, E/E’, hypertension group and normal group difference of NT-proBNP were significantly statistically significant.