The prediction value of the ambulatory blood pressure monitoring parameters on different degree heart damage and carotid artery intima-media thickness in heart failures

Objective To explore the relationship between change of ambulatory blood pressure mo- nitoring(ABPM),carotid artery intima-media thickness(IMT)and different damage of heart function in pa- tients with heart failure.Methods We evaluated 86 heart failure patients who were never treated regularly before.All patients underwent ultrasound examinations of the heart and the IMT of carotid arteries.We divid- ed them into two groups:group A(n=42,heart function classⅡ,EF45～35%),group B(n=44,heart function elassⅢⅣ,EF35%)The record of medical history,physical examination and 24 h ambulatory blood pressure monitoring(ABPM)were performed in all the patients.The biochemical parameters such as blood lipids glucose and so on were tested.Then the data comparison was made.Results(1)there were no significant differences in clinical manifestations and biochemical parameters between the group A(heart function classⅡ,EF45～35%)and groupB(heart function classⅢ,ⅣEF35% and P0.05.Age(62.1 +5.8)year vs(65.6±6.2)year,male 72.3% vs 62.7%,body mass index(22.3±4.7)vs(23.2±4.1)kg/m,diabetes mellitus and(or)impaired glucose tolerance 40.0% vs 38.2%,angina pectoris 42.3% vs 39.0%,eerbral vascular diseases 19.2% vs 14.3%,total cholestero(5.3±1.5)vs(5.4±1.37) mmol/l,triglycerides(1.8±1.02)vs(86±1.01)mmol/l,low-density lipoprotein cholesterol(4.06±1.48)vs(4.02±1.49)mmol/l,high-density lipoprotein cholesterol(0.89±0.21)vs(1.00±0.30) mmol/l(2)The parameter of ABPM in group A(heart function classⅡ,EF45～35%)and groupB(heart function classⅢ,ⅣEF35%),There were singnificant differences(P0.05),in 24h mean systolic blood pressure(128.3±10.3)vs(106.7±9.3)mmHg,24h mean diastolic blood pressure(83.4±6.0)vs (80.2±8.8 )mm Hg,daytime mean systolic blood pressure(130.2±12.8)vs(110.2±10.1)mm Hg,day- time mean diastolic blood pressure(84.9±8.9)vs(82.1±9.0)mm Hg,,nighttime mean systolic blood pressure(120.1±10.2)vs(98.2±108)mm Hg,nighttime pulse pressure(38.2±9.8)vs(34.9±10.1) mm Hg;daytime pulse pressure(42.8±9.6)vs(38.2±8.8)mm Hg;24h systolic blood pressure variance (8.0±2.0)vs(7.2±1.0);24h diastolic blood pressure variance(8.0±2.1)vs(9.3±2.0),the non-dip- per rhythm of ambulatory blood pressure55.6% vs 87.7%,(3)There were also no significant difference in clinical manifestations between the IMT increased and no IMT increased group in those parameters of ABPM (P0.05),while there were significant differences between the IMT increased and no IMT increased group in those parameters of ABPM(P0.05).Conclusion The prevalence of ABPM abnormality and IMT were correlated with the degree of heart failure.ABPM and IMT act as valuable parameters in heart function class.