Evaluation Of Artery Elasticity In Patients Of Hypertension And Diabetes By Doppler Ultrasound

Background and purposeArterial wall structure and vascular function was impaired before the damages of target organs in patients with hypertension and diabetes,showing as the decrease of arterial elasticity and the thickening of intima-media,which is a subclinical stage of cardiovascular diseases.The evaluation of artery elasticity chould provide a reliable basis for early intervention and treatment in patients with hypertension and diabetes,and reduce the incidence and mortality of cardiovascular diseases.The purpose of this study is to evaluate the value of Doppler ultrasound guided index in detecting arterial function in patients of hypertension and diabetes mellitus.MethodsObjectives: 310 consecutive patients of outpatient and inpatient in our hospital from Oct.2015 to Nov.2018 were recruited in this study.The patients were divided into normal control group(80 cases,group A),hypertension group(70 cases,group B),diabetes group(70 cases,group C),and hypertension with diabetes group(90 cases,group D).General clinical data were recorded and ultrasound images and data were collected.It includes:(1)carotid intima-media thickness(cIMT);(2)Aortic root-abdominal aorta mechanical wave conduction time(Tt'): the time difference between the pulse wave conduction from the anterior wall of the aortic root to the anterior wall of the abdominal aorta,and the Tt'was obtained from the front and back of the university.(3)aortic-dorsal pedal artery blood flow conduction time(Tf'): the time difference between aortic valve orifice blood flow conduction and dorsal pedal artery blood flow conduction,and Tf'was obtained after going through university.(4)The anterior wall of abdominal aorta dilatation D: The anterior wall motion curve of abdominal aorta was measured by TDI pulse mode,and then Tissue Track was performed by Q-Analysis to obtain the anterior wall dilatation D of abdominal aorta.Results 1.Compared with the normal control group,the time of Tt',Tf'in hypertension group,diabetes group and hypertension combined with diabetes group were shorter,the anterior aortic wall dilatation D was smaller,and the cIMT was thicker(all P < 0.05).In addition,Tt',Tf',and aortic anterior wall dilatation D in hypertension with diabetes mellitus group were shorter and smaller than those in hypertension group and diabetes mellitus group(all P < 0.05).However,there was no significant difference in carotid IMT among the three groups(p > 0.05).2.The time of mechanical aortic wave and blood flow conduction Tt',Tf',and the extent of anterior abdominal aortic wall dilation D were negatively correlated with systolic blood pressure,diastolic blood pressure,pulse pressure and blood sugar(r=-0.33~0.55,P < 0.01).Multivariate regression analysis showed that systolic blood pressure and blood sugar were independent influencing factors of the above indicators.Conclusion 1.Decreased arterial elasticity in patients of hypertension and/or diabetes can be detected by mechanical wave or flow conduction time in artery obtained by tissue Doppler and flow Doppler,and the changes of arterial dilatation can also be obtained by tissue Doppler,suggesting that Doppler ultrasound might provide an optional non-invasive method for evaluating arterial function.2.Compared with two-dimensional finding of carotid IMT,Doppler guided mechanic wave conduction time and arterial dilatation might better reflect the degrees of artery function impairment in patients of hypertension and/or diabetes.