| Objective:Two-dimensional speckle tracking imaging(2D-STI)was used to quantitatively evaluate myocardial strain in elderly hypertensive patients,and the changes of myocardial mechanics in elderly hypertensive patients with different blood pressure control levels were observed.And further analyze the related factors affecting the myocardial strain reduction in elderly patients with hypertension.Methods:505 elderly hypertensive patients admitted to the Department of Cardiology,Shanxi Grand Hospital from October 2016 to September 2018 were selected as the hypertension group.According to the blood pressure control level,they were divided into a good blood pressure control group(295 cases)and a poor blood pressure control group(210).For example,150 elderly people with age and sex matched with no cardiovascular and cerebrovascular diseases were selected as the control group.Left ventricular wall strain(GLS-endo),middle layer strain(GLS-mid),outer layer strain(GLS-epi)and overall longitudinal strain(GLS)were obtained from 3 groups of subjects using 2D-STI.Adopt ANOVA was used in the hypertension group compared with the control group,comparison in pairs shall adopt LSD-t test.According to left ventricular GLS,the components with good blood pressure control were GLS normal group(GLS?-17%)andGLS reduction group(GLS>-17%).Chi-square test was used to compare the differences between general clinical data and conventional echocardiographic parameters between the two groups,such as age,gender,course of hypertension,family history of hypertension,BMI,waist circumference,blood sugar,blood lipids,blood uric acid,serum creatinine,smoking,drinking and so on.To analyze the influencing factors of GLS reduction in elderly patients with well-controlled blood pressure.Results:(1)Two-dimensional echocardiography routine measurement parameters: Compared with the control group,the E/e' of the well-controlled blood pressure group increased,and the LVMI,RWT,E/e' of the poor blood pressure control group increased,the difference was statistically significant(P<0.05);compared with the group with well-controlled blood pressure LVMI and RWT increased in the poor blood pressure control group,and the difference was statistically significant(P<0.05).(2)Two-dimensional echocardiography strain parameters: Compared with the control group,the GLS-endo and GLS were decreased in the well-controlled blood pressure group,the difference was statistically significant(P<0.05),and the GLS-endo,GLS-mid,GLS-epi and GLS were all decreased in the poor blood pressure control group.Small,the difference was statistically significant(P<0.05);compared with the well-controlled group,the GLS-endo,GLS-mid,GLS-epi and GLS were all decreased in the poor blood pressure control group,the difference was statistically significant(P<0.05).(3)In Chi-square test analysis,GLS was reduced with hypertensive course(OR=2.98,95% CI 1.35–6.67;P= 0.005),overweight(OR = 3.93,95% CI)2.19-7.05;P<0.001),obesity(OR = 3.74,95% CI 1.69-8.29;P= 0.001),impaired glucose tolerance(OR= 2.05,95% CI 1.22-3.43;P=0.006),TG abnormalities(OR = 2.67,95% CI 1.58-4.51;P<0.001),HDL-C abnormalities(OR = 2.36,95% CI 1.21-1.63;P< 0.001),left ventricular wall hypertrophy [central hypertrophy(OR=2.70,95% CI 1.34-5.46;P= 0.005),eccentric hypertrophy(OR = 6.48,95% CI 2.77-15.14;P< 0.001)),] and E/e'(OR = 4.15,95% CI2.32-7.45;P< 0.001)related.In multivariate analysis,GLS reduction was associated with hypertension course,BMI,impaired glucose tolerance,dyslipidemia,left ventricular wall hypertrophy,and E/e'.Conclusion:(1)Left ventricular myocardial mechanics is impaired in elderly hypertensive patients.(2)The myocardial mechanics of the poor blood pressure control group was worse than the blood pressure control group.(3)The well-controlled blood pressure GLS reduction in elderly hypertensive patients was associated with hypertension course,BMI,blood glucose,blood lipids,left ventricular wall hypertrophy and E/e'. |
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