Discussion Of The Relationship Between H-type Hypertension And H-type Pre-hypertension With Left Ventricular Remodeling

Objective In this research we will figure out the following points by gather clinical and laboratory information :1.Relationship between homocysteine and hypertension;Relationship between homocysteine and pre-hypertension.2.wheather there is sygernic function in left ventricular remodeling when hyperhomocysteinemia(HHcy)accompany whith hypertension or pre-hypertension.Meanwhile,if there is a geaver risk in left ventricular remodeling when they conme together.3. Figure out the relationshiop between homocysteine and MTHFR gene polymorphism,in addition, make sure an susceptibility gene leading to left ventricular remodeling.Methords Choose 965 TianjinChest Hospital Cardiology in-patients and divide them into 4 groups based on their plasma homocysteine level and whether suffer from hypertension. Then analyse and compare left ventricular systolic diamter( LVEDD)、left ventricular diastolic diamter(LVESD)、interventricular septum thickness(IVST)、left ventricular relative thickness(LVRT)、Left ventricular mass index(LVMI)、E/A、the proportion of left ventricular remodeling in the 4 groups. Meanwhile, devide the non-hypertension patients into pre-hypertension group and normal group according to blood pressure.Analysisi and compare plasma Hcy, Glu, Cr, UA, TC, TG, LDL, VLDL, HDL and so on. Observe the cardiac uhrasonogrphy index such as LVEDD, LVESD, IVST, LVPWT, LVRT, LVMI and son on in the four groups. Analysis and compare MTHFR genotype and the relationship between the MTHFR gene and left ventricular remodeling.Results 1.There is no statistal significant difference of the baseline date in the four groups.2.There is positive correlation between plasma Hcy and systolic blood pressure(SBP)and diastolic blood pressure(r=0.932、0.975, P<0.01).3. The Htype hypertension Group has a higher level in LVEDD、LVESD、LVRT、LVMI、the proportion of left ventricular remodeling copared to the other 3 groups(P<0.05)4.Logistic regression analysis show that HHcy 、hypertension and both of them are the risk factors in the left ventricular remodeling(OR=53.47、72.80、77.50,P<0.05)5. TT and TC gene are the risk factors in leading to left ventricular remodeling 6.There are significant differences of the LVEDD 、 IVSTand E/A between the Pre-hypertension group and normal group(P<0.05),but other cardiac uhrasonogrphy index have no stistical difference(P<0.05).7. The proportion of left ventricular remodeling in the TT、TC、CCgene also doesn’t reach a significant stitical difference when compare the pre-hypertension group and nomal group.Conclusion Plasma Hcy has a positive correlation with SBP and DBP, and can promote hypertension occur and development. HHcy 、hypertension and both of them are the risk factors in the left ventricular remodeling. MTHFR gene polymorphisms has an positive correlation whith hyperhomocysteinemia and left ventricular remodeling,in addition,H-type hypertension patients with TT gene seemingly has a higher risk in left ventricular remodeling.