Assessment Of Right Ventricular Systolic Function In Hypertensive Patients By Four-Dimensional Quantitative Analysis Of Right Ventricular Volume

Background: As of 2014,there are nearly 300 million people with hypertension in China,uncontrolled high blood pressure population all-cause mortality and major cardiovascular events are at higher risk,and persistent hypertension can cause left ventricular Increased afterload and lead to left ventricular remodeling.Left ventricular remodeling is characterized by ventricular myocyte proliferation,left ventricular concentric or centrifugal hypertrophy..The development of ventricular remodeling can seriously affect the heart function,severe cases and even further affect the right ventricular morphology and function,manifested as right heart Dilated and contractile function decline,accurate quantitative assessment of the right ventricle for the development of clinical decision-making with an important role,the application of echocardiography three-dimensional volume analysis technology,without special right ventricle form of the impact of more accurate and convenient determination of hypertensive patients with early right heart morphology and function change.Objective: Four-dimensional quantitative analysis of right ventricular volume(4D-RV-Volume)was used to analyze the changes of right ventricular systolic function at different stages of hypertension with or without left ventricular hypertrophy.Methods: To obtain the patients who underwent echocardiography from July 2017 to July2018 in the PLA General Hospital,selected patients with hypertension were included in this study and matched with the normal control group according to their demographic characteristics.According to the left ventricular mass index(LVMI),it was divided into normal LVMI group and LVMI high group.After two-dimensional right ventricular function was evaluated routinely,RVEF% and 2D long axis strain rate of right ventricular free wall were measured by 3D volumetric method(RVFLS%),area change fraction(FAC)and tricuspid annulus systolic displacement(TAPSE)were calculated.The differences between groups were compared and compared with the two-dimensional right ventricular function parameters.Results : According to the inclusion and exclusion criteria,a total of 200 patients were screened in the time window,which satisfied the conditions of enrollment.A total of 161 patients were excluded.Excluding the sound window was not satisfactory,after 12 follow-up analysis was difficult,a total of 149 patients,of which normal The control group consisted of53 males(26males and 27females),49 LVMI normal subjects(25 males and 24 females)and46 LVMI increased patients(23 males and 23 females).There was no significant difference in smoking history,complications and so on.LVMI and BSA increased in LVMI increase group(P<0.05).The left ventricular ejection fraction in the three groups were in the normal range,the LVMI increased group(61±7.7%)was lower than the normal group(64± 6.9%),Left ventricular end-diastolic volume and left ventricular end-systolic volume were 42.9 ±12.7 ml)(P < 0.05).The RVEF of the hypertension group was lower than that of the normal control group(P <0.05).the left ventricular end-diastolic volume and left ventricular end-systolic volume 42.9±12.7ml)(P<0.05).The RVEF of hypertension group was lower than that of the normal control group(P<0.05).The RVEF and RVFLS of the LVMI increased group were lower than those of the normal LVMI group(P<0.05).Person correlation analysis showed that there was a good correlation between RVEF and FAC measured by4D-RV-volune technique(r = 0.721,P<0.01).Conclusion:1.Long-term blood pressure can cause changes in cardiac structure and function,such as the expansion of the heart chamber,wall thickening,decreased cardiac function.2.Long-term load increase caused by left ventricular remodeling,and further lead to changes in right ventricular morphology and function.Accurate determination of right heart function plays an important role in the treatment and prognosis of the disease.3.RT-3DE is more accurate and convenient than two-dimensional ultrasound in determining right ventricular volume in different periods of hypertension,to assess right ventricular function.4.Person correlation analysis showed that there was a good correlation between RVEF and FAC measured by 4D-RV-volune technique(r=0.721,P<0.01).5.According to ASE echocardiography guidelines,RVEF?45% was used as the cutoff value.The proportion of LVMI increased compared with LVMI normal and control groups increased significantly...