The Ultrasonic Investigation of Endothelial Function in Patients with Hypertensive Heart Disease

Objective To investigate the vascular endothelial function in patients with hypertensive heart disease by high-resolution colour ultrasonography.Methods 30 patients were in hypertensive heart disease group,32 patients were in primary hypertension group and 21 patients were in normal control group.With high-resolution colour ultrasonography,vascular diameter(D) and blood flow volume(FV) were measured in the basic condition,after reactive hyperemia and nitroglycerin sublingually respectively.The research parameter including basic diameter of brachial artery(BD),percentage of diameter change of reactive hyperemia and nitroglycerin sublingually [ RH△D(%),NTG△D(%)];basic flow volume of brachial artery(BF),flow volume after reactive hyperemia and nitroglycerin sublingually(RHF,NTGF),percentage of flow volume change of reactive hyperemia and nitroglycerin sublingually [ RH△F(%),NTG△F(%) ] were measured to assess the flow-mediated dilation(FMD) of brachial artery.Results ① The function of endothelium-dependent and endothelium-independent dilatation in patients with and without hypertensive heart disease had significantly decreased compared with that of patients in normal control group(P 0.05);② The function of endothelium-dependent and endothelium-independent dilatation in patients with hypertensive heart disease had significantly decreased compared with that of patients with primary hypertension;③ Multivariate regression analysis showed that endothelium-dependent dilatation in patients with hypertensive heart disease was significantly negatively related with SBP(r =-0.73,P 0.05)、DBP(r =-0.66,P 0.05)、TG(r =-0.48,P 0.05)、LDL-C(r =-0.41,P 0.05) and course(r =-0.44,P 0.05) respectively.Conclusion ① Endothelial dysfunction in patients with hypertensive heart disease is more apparent than that of in patients with primary hypertension,which suggests that endothelial dysfunction may be one of the pathogenesis of hypertensive heart disease.② Endothelium-dependent dilatation in patients with hypertensive heart disease is significantly negatively related with the level of blood pressure,dyslipidemian(especially triglyceride and low-density lipoprotein cholesterol) and course.③ High-resolution colour vascular ultrasonography,as a noninvasive approach to detect endothelial dysfunction,has the advantages of simplicity,convenience,high reproducibility and accuracy.