scholarly journals The relationship between left ventricular diastolic function and the autonomic nervous function in elderly patients with mild-to-moderate essential hypertension

2018 ◽  
Vol 5 (3) ◽  
pp. 8
Author(s):  
Qunwei Liu ◽  
Xin Lin ◽  
Lei Dong ◽  
Limin Han ◽  
Feng Chang
Keyword(s):  
Essential Hypertension ◽  
Elderly Patients ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Moderate Essential Hypertension ◽  
Autonomic Nervous Function ◽  
Autonomic Nervous ◽  
Ventricular Diastolic Dysfunction ◽  
Nervous Function

Objective: To investigate the relationship between left ventricular diastolic function (LVDF) and autonomic nervous function in elderly patients with mild-to-moderate essential hypertension.Design: A total of 146 elderly patients with mild-to-moderate essential hypertension were enrolled in our hospital from January, 2015 to October, 2017. Blood pressure was recorded, and biochemical indexes and the N-terminal pro-brain natriuretic preptide (NT-proBNP) were investigated. 2-dimensional echocadiolography was used to measure the parameters of LVDF. Based on the classification standard of LVDF, all subjects were divided into two groups: normal LVDF group (n = 72), left ventricular diastolic dysfunction group (n = 74). At the same time, the dynamic electrocardiogram were investigated for all subjects to monitor the indexes of time on heart rate variability (HRV).Results: (1) The level of NT-proBNP, left ventricular mass index (LVMI), interventricular septal thickness (IVST) and LVPWT increased significantly (p < .05 for all), while the level of PNN50, rMSSD, SDANN and SDNN decreased significantly (p < .05 for all) in left ventricular diastolic dysfunction group (abnormal LVDF group) compared with that in normal LVDF group (normal LVDF group); (2) The partial correlation analysis showed that rMSSD, PNN50 and triangle index were negatively correlated with peak A (r = -0.208, -0.219, -0.211, p < .05 for all), and positive correlated with the ratio of peak E to peak A (E/A) (r = 0.179, 0.184, 0.181, p < .05); SDNN were negatively correlated with NT-proBNP and E/E’ (r = -0.183, -0.181, p < .05 for all), positive correlated with E’ (r = 0.178, p < .05); (3) Multiple stepwise regression analysis showed that peak A and E/A were independent influencing factors for PNN50 (β = -0.261, p = .004; β = 0.179, p = .016); E/E’ and NT-proBNP were independent influencing factor for SDNN (β = -0.163, p = .018; β = -0.172, p = .022).Conclusions: Left ventricular diastolic dysfunction is closely related to impaired autonomic nervous function in elderly patients with mild-to-moderate essential hypertension.  

scholarly journals Microalbuminuria as a Marker of Preclinical Diastolic Dysfunction in Newly Diagnosed and Never-Treated Essential Hypertension

2013 ◽  
Vol 35 (1) ◽  
pp. 3-8
Author(s):  
RM Gajurel ◽  
A Sayami
Keyword(s):  
Essential Hypertension ◽  
Diastolic Dysfunction ◽  
Myocardial Dysfunction ◽  
Public Health Problem ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Newly Diagnosed ◽  
Spot Urine ◽  
Functional Changes ◽  
Ventricular Diastolic Dysfunction

Introduction: Hypertension (HTN) is a global public health problem with one fourth adults worldwide estimated to have high blood pressure (BP)1 The incidence of hypertension continues to increase in all developed and developing societies as the population grows older and more obese. The Framingham Study and other epidemiological surgeys have clearly defined HTN as an important cause of morbidity and mortality. The aim of this study was to determine the spot urine Microalbuminuria as a marker of preclinical cardiac structural and functional changes in the form of left ventricular diastolic dysfunction in newly diagnosed and never treated essential hypertensive subjects. Methods: A cross sectional study was used for those patients who were attended outpatient clinic of MCVTC with diagnosis of newly diagnosed and never treated hypertension over a period of October 2011 to November 2012. Results: A total of 130 essential hypertensive patients underwent for spot urine for microalbuminuria estimation and Echocardiography for evaluation of left ventricular diastolic function. Among 56 (43.1%) urine samples showed negative test [(Microalbuminuria -); ( UACR 30 mg/Gm)] and those 74 (56.9%) samples revealed positive test [(Microalbuminuria+); (UACR 30 to 300 mg/Gm)]. Patients with microalbuminuria positive was found to have more left ventricular diastolic dysfunction than those who were negative for Microalbuminuria. Conclusion: Microalbuminuria was found to have early preclinical marker of myocardial dysfunction in the form of left ventricular diastolic dysfunction in new and never treated essential hypertension. DOI: http://dx.doi.org/10.2126/joim.v35i1.8890  Journal of Institute of Medicine, April, 2013; 35:3-8

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