Research On The Associations Between Hypertension Myocardial Fibrosis,CTRP9 Levels And TCM Syndromes Based On "Two-dimensional Speckle Tracking Imaging Technology"

Objective:1.The study try to probe the associations between hypertensive myocardial fibrosis and CTRP9 levels,to find the role of CTRP9 in the occurrence and development of hypertensive myocardial fibrosis,and to lay the foundation for seeking biological targets for the prevention and treatment of hypertensive myocardial fibrosis.2.The aim of the research is to explore the associations between hypertensive myocardial fibrosis and TCM syndromes,in order to provide reference for clinical differentiation and treatment of early target organ damage of hypertension based on TCM syndromes.Methods:The study was conducted epidemiological investigations in Danyang city,Jiangsu province in June 2017,June 2018 and May 2019 respectively.The subjects(n=3032)were mainly from residents of the station community.The collection included basic personal information,serological samples,and echocardiographic measurement indicators.Subjects with hypertension were asked to fill in the quantitative standard form of hypertension symptom grading and we type symptoms according to the scale.We detected CTRP9 in the hospital laboratory.Finally,We perform statistical analysis on the collected data.Results:1.Compared with the normal blood pressure group,the hypertension group was older(+5.25 years old),had a higher incidence of smoking,drinking and diabetes(P<0.05),had higher blood glucose level(+0.44mmol/L),had higher triglycerides and cholesterol(TG+0.29mmol/L,TC0.26mmol/L),and had lower HDL level(-0.05mmolL),and had decreased renal function(egfr-5.8 ml/min,ACR+8.82).In terms of cardiac structure and function,people with hypertension had thicker ventricular wall thickness(LVPW+0.7mm)and higher left ventricular mass index(LVMI+12.6gm2),and their diastolic function was different from that of the normal blood pressure group(E/A-0.22).2.The population was divided into three groups according to serum CTRP9 tertiles.The three groups had statistically significant differences in BMI,WC,SBP,Glu,eGFR,ACR,and LVD,and the differences in GLS had marginal statistical significance.Compared with the CTRP9 concentration group in the upper and lower thirds,higher BMI(P=0.002),higher waist circumference(P=0.006),higher systolic blood pressure(P=0.035),higher blood glucose(P=0.042),higher ACR(P=0.02),larger LVD(P=0.03)and lower GLS(P=0.05)were observed in the middle thirds group.However,no significant statistical difference was found in the CTRP9 concentration group in the upper and lower thirds.3.There was a correlation between CTRP9 and EF in normal blood pressure groups(P=0.037),and no significant correlation was observed in CTRP9 in the hypertension group.After multivariate adjustment,the observed EF correlation disappeared in the normal blood pressure group(P=0.055),while in the hypertension group,CTRP9 was associated with smoking(P=0.034).No correlation was found between CTRP9 and GLS in either the normal blood pressure group or the hypertension group(P>0.05).4.Gender BMI diastolic blood pressure heart rate EF,LVD,LVMI,E/A was an independent factor affecting GLS.Among them,GLS was negatively correlated with BMI,diastolic blood pressure,heart rate,and LVMI,and positively correlated with EF,LVD,and E/A.No significant correlation was found with CTRP9.5.The hypertension group with the yin and yang deficiency group was the oldest and showed lower BMI,WC,systolic/diastolic blood pressure,heart rate,blood glucose,Tg,and LDL(P<0.001).Systolic and diastolic blood pressure were the highest,heart rate was the fastest and ACR was the highest(P<0.001),and BMI blood glucose TC was the highest(P<0.001)in the phlegm-dampness syndrome group,while the indicators of Yin deficiency and Yang hyperactivity syndrome group were mostly in the middle of the four groups.6.In terms of left ventricular structure and function,Phlegm-dampness syndrome had the highest LVD and LVPW,and the lowest GLS,and showed significant difference as compared with yin and yang deficiency syndrome.(P<0.05).Conclusion:1.There may be a correlation between myocardial fibrosis and CTRP9 levels,and its mechanism has yet to be confirmed by further research..2.The degree of myocardial fibrosis in hypertensive phlegm-dampness syndrome is the most serious.3.Myocardial fibrosis is negatively correlated with BMI,diastolic blood pressure,heart rate,and LVMI,and positively correlated with EF,LVDand E/A.Compared with women,myocardial fibrosis is more severe in men.