The Study Of Early Cardiovascular Function By Wave Intensity Technique And The Correlation Between Parameters Of Wi And Biochemical Indicators In Patients With Chronic Renal Failure

Part One The Study of Early Heart Function and Vessel Elasticity by Wave Intensity Technique in Patients with Chronic Renal FailureObjective: To investigate the damage of early heart function and vessel elasticity using wave intensity technique in patients with chronic renal failure.Method: 30 patients with CRF and primary hypertension and 32 control subjects were recruited.ALL patients have normal left ventricular ejection fraction(LVEF>55%).W1(acceleration wave intensity),NA(negative area), W2(deceleration wave intensity),the time between electrocardiogram R wave apex and W1 wave apex(R-W1),internal time between W1 and W2(W1-W2), β(stiffness index),Ερ(press-wave elastic modulus),AC(arterial compliance), AI(augmentation index),PWVβ(pulse wave velocity) were obtained at the level of right common carotid artery(CCA)by wave intensity technique.at the same time LVEF was measured by M-mode ultrasonography in left ventricular long-axis view.In the apical four-chamber view,early diastolic transmitral inflow velocity(E) and early diastolic mitral annulus velocity(e) were recorded by pusled-wave Doppler and Doppler Tissue Imaging. Calculate the ratio of E and e.Result:1. There was no significant difference among these groups in age,sex and body area.Compared with the hypertension group and the normal control group,the heart rate of CRF group increased(P<0.05);Compared with the normal control group,the systolic and diastolic blood pressure and pulse pressure of the CRF group and the hypertension group increased(P<0.05),but there was significant difference the between CRF group and the hypertension group.2.E/e in the CRF group and the hypertension group was significantly higher than that in the normal control group,but there was no significant difference between the CRF group and the hypertension group.There was no significant difference among there groups in LVEF.3.Compared with the normal control group, W1、W2、NA、R-W1、β、Ερ、AC、PWVβ were higher in patients with the CRF group and the hypertension group(P<0.05),however there was no significant difference in W1-W2、AI(P>0.05).Compared with the hypertension group,W1、NA、β were higher in the CRF group(P<0.05)and there was no significant difference in W2、R-W1、W1-W2、Ερ、AC、AI、PWVβ(P>0.05).Conclusion:1.The heart function had been impaired in patients with CRF and primary hypertension.In the case of normal LVEF WI technique can evaluate early cardiovascular damage and W1 is much more sensitive to evaluate the left ventricular systolic function than LVEF.2.The vessel function had been impaired in patients with CRF and primary hypertension and WI technique can evaluate the damage of vessel function before the vessel is impaired without morphological change.3.Cardiovascular function had been impaired in patients with all CRF accompanied with hypertension and primary hypertension patients.The cardiovascular function is worse in patients with CRF accompanied with hypertension. Part Two Correlation between Wave Intensity,Vascular Elasticity and Clinical Blood Biochemical Indicators of Patients with Chronic Renal FailureObjective: To detect parameter index of cardiovascular function byusing wave intensity technique and to discuss the correlation between waveintensity and vessel elasticity indicators as well as blood biochemical indicators of Patients With Chronic Renal Failure.Method: 60 patients with CRF were recruited.W1(acceleration wave intensity),NA(negative area),W2(deceleration wave intensity),the timebetween electrocardiogram R wave apex and W1 wave apex(R-W1),internaltime between W1 and W2(W1-W2),β(stiffness index),Ερ(press-wave elasticmodulus),AC(arterial compliance), AI(augmentation index), PWVβ(pulsewave velocity) were obtained at the level of right common carotid artery(CCA)by wave intensity technique.Clinical biochemical indicators wereprovided by the department of clinical laboratory. Clinical biochemicalindicators included TG,TC,HDL-C,LDL-C,apo A1,apo B1,LP(a),Urea,Crea,UA,hs CRP(hypersensitive C reactive protein),HCY(homocysteine),TCa(totalcalcium), IP(inorganic phosphorus),etc.Correlation analysis was madebetween wave intensity and vessel elasticity indicators as well as blood biochemical indicators of Patients With Chronic Renal Failure.Result:1.Correlation between parameters of wave intensity and vascular elasticity :W1was positively correlated with β、Ερ、PWVβ(r=0.582,0.478,0.390, P<0.01), and was negatively correlated with AC( r=-0.357, P<0.01).W2 was negatively correlated with AI(r=-0.336,P<0.01).R-W1 was positively correlated with AC( r=0.334, P<0.01) and was negatively correlated with β、Ερ、PWVβ(r=-0.503,-0.388,-0.346,P<0.01).2.Correlation between indicators of WI technique and heart rate,BSA,blood pressure,pulse pressure :W1 was positively correlated with systolic pressure(r=0.290,P<0.05)and negatively correlated with diastolic pressure(r=-0.299, P<0.05).NA was positively correlated with systolic pressure(r=0.496, P<0.05).R-W1 was positively correlated with diastolic pressure(r=0.394, P<0.05).W1-W2 was negatively correlated with heart rate and diastolic pressure( r=-0.282,-0.360,P<0.05).β was positively correlated with systolic pressure( r=0.271,P<0.05).Ερ was positively correlated with systolic pressure(r=0.517,P<0.01).AC was negatively correlated with systolic pressure( r=-0.452,P<0.01).AI was negatively correlated with heart rate(r=-0.459,P<0.01).PWVβ was positively correlated with systolic pressure(r=0.526,P<0.01).3.Correlation between parameters of WI technique and clinical blood biochemical indicators :IP,Urea were positively correlated with NA(r=0.361, 0.291,P<0.05),and TCa was negatively correlated with NA( r=-0.331, P<0.05).Crea was positively correlated with W2 、 NA 、 Ερ 、 PWVβ(r=0.281,0.333,0.264,0.299,P<0.05).There was no correlation among the indicators of WI technique, blood lipids,hs CRP and HCY. Conclusion:1.In the case of normal LVEF and before vascular morphological change,vascular elasticity decreased while the cardiac function was damaged in patients with CRF.2. blood pressure can affect the early cardiovascular function in patients with CRF,namely,blood pressure increased while cardiac systolic function was increased and vascular elasticity function was reduced.3.Blood calcium,phosphorus,blood creatinine levels may directly affect vascular peripheral resistance in patients with CRF.Creatinine levels may also affect the early vascular elasticity function,namely the creatinine increased while the vascular elasticity was reduced.