The Relationship Between Left Ventricular End-systolic Biomechanical Changes And Diastolic Heart Failure

Objective In terms of the relations among maxEav ? Emax and E/A value in patients with essential hypertension,the study is suppose to explore the maxEav and Emax is sensitivity of the end of left ventricular systole,and it is direct biomechanical indexes for evaluating myocardial diastolic function,and biomechanical mechanism of diastolic heart failure.Methods(1)298 patients with essential hypertension were selected as the research object in the Second affiliated hospital of baotou medical college.The left ventricular mass index and relative wall thickness were diagnosed and divided into four based on LVMI and RWT.The groups were left ventricular normal,left ventricular concentric remodeling,left ventricular eccentric hypertrophy,left ventricular concentric hypertrophy.Another 115 healthy persons were selected as control group.(2)Five groups of subjects were examined by conventional three-dimensional echocardiography.The R-wave and T-wave vertices were used as the end-diastolic and end-systolic phases of the left ventricle,respectively.The left ventricle in the long-axis view of the left ventricle near the sternum and the four-chamber view of the apex were taken from the left ventricle.Measurement the index of the Left ventricular end-systolic dimension(LVESD),left ventricular end-diastolic dimension(LVEDD),Left ventricular end-systolic posterior wall thickness(LVPWs),The end-systolic of Left ventricular midwall long axis diameter(Lmes),The end-systolic of Left ventricular midwall short axis diameter(Dmes),The end-systolic of Left ventricular wall thickness(Hes).The blood pressure of the right arm cuff was recorded simultaneously;Maximum myocardial stiffness(maxEav)and Myocardial maximum elastic modulus(Emax)at the end of systolic phase were calculated.(3)This study used the measurement data was expressed by means of(x ±S);the comparison between groups was performed by analysis of variance;For the two-variable correlation analysis,the two-variable correlation analysis was performed by t-test or corrected t-test.The difference statistical significance was set toP<0.05.Results(1)Correlation analysis between maxEav,Emax and E/A value of the five groups(1)The maxEav of the LVCH group was significantly negatively correlated with the E/A value(r=-0.417,P< 0.01).(2)The maxEav andE/A value of the LVCH group were significantly negatively correlated(r=-0.366,P<0.05),the Emax of the LVCH group was significantly negatively correlated with the E/A value(r=-0.491,P<0.01).(3)The maxEav was significantly negatively correlated with E/A value in the LVCR group(r=-0.404,P<0.01),the Emax and E/A value in the LVCH group Significant negative correlation(r=-0.235,P<0.05).(2)LVN group,LVCR,LVEH,and LVCH and control group maxEav,Emax and E / A Comparison: The difference of E/A value between LVCR group,LVCH group and control group was P<0.05,the difference was statistically significant,and the difference of E/A value between the other groups was P>0.05.There was no significant difference and it was not statistically significant.There was no significant difference in the Emax and E/A between the eccentric hypertrophy group(P>0.05).The difference of maxEav and E/A in the eccentric hypertrophy group was statistically significant(P<0.05).There was no significant difference in the maxEav,Emax and E/A between the normal configuration groups(P>0.05).The maxEav,Emax and E/A of the eccentric hypertrophy group were significantly increased compared with the other groups,the difference was statistically significant(P<0.05);(3)Compared with the control group,The maxEav and Emax of each group of hypertension decreased,and the difference was statistically significant(P<0.05).The difference was statistically significant.Conclusion Analysis of maxEav and Emax is a more sensitive and simple index for judging left ventricular diastolic function.Simultaneous analysis of changes in myocardial maxEav,Emax in patients with left ventricular remodeling and diastolic dysfunction The pathogenesis of diastolic heart failure provides a theoretical basis for the prevention and treatment of diastolic heart failure in the future.