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Objective To explore the relationship between the fall of postprandial blood pressure and superior mesenteric artery (SMA) blood flow in elderly patients aged 80 years and over.Methods The study included 25 inpatients aged 80 years and over with postprandial hypotension (PPH group) and 27 age matched cases without PPH (control group).The changes in blood pressure and the hemodynamics of SMA at fasting stage and 2 hour after meal were observed.The differences between the two groups were compared.Results The incidence of abnormal glucose metabolism (including diabetes and impaired glucose tolerance) was significantly higher in PPH group than in control group [[92.0％ (23 cases) vs.40.7％ (11 cases), P＜0.05].There were no significant differences in other clinical data between the two groups (all P＞0.05).The blood pressure in two groups at different time points was decreased after meal significantly as compared with that at fasting stage (all P＞0.05).The maximal fall of postprandial systolic blood pressure and diastolic blood pressure was significantly increased in PPH group as compared with in control group [(31.3± 14.8)mmHg(1 mmHg=0.133 kPa) vs.(6.9±16.5) mmHg, (13.1±6.6) mmHg vs.(9.0±3.9)mmHg, both P＜0.05].The postprandial SMA blood flow at different time points was significantly increased after meal as compared with that at fasting stage in two groups (all P＞0.05).The maximal increase of postprandial SMA blood flow was larger in PPH group than in control group [(550.5±149.5) ml/min vs.(312.8±241.4) ml/min, P＜0.05].The maximal fall of postprandial systolic blood pressure was positively associated with the maximal increase of postprandial SMA blood flow (r=0.352, P=0.025).Conclusions The fall of postprandial blood pressure is associated with the increase of the SMA blood flow.Postprandial increase in splanchnic perfusion is one of the mechanisms for the formation of PPH.
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Objective To investigate the relationship of blood pressure variability(BPV) and heart rate variability(HRV) with prostatic volume (PV) in patients with benign prostatic hyperplasia (BPH).Methods A total of 133 patients admitted to our department between January 2011 to April 2013 were analyzed retrospectively.The patients were divided into BPH group and non-BPH group according to the PV value.The ambulatory blood pressure monitoring was used to measure the blood pressure parameters,including 24-hour systolic blood pressure (SBP),24-hour diastolic blood pressure (DBP),day time systolic blood pressure(DSBP),day time diastolic blood pressure (DDBP),night systolic blood pressure (NSBP),night diastolic blood pressure(NDBP),the standard deviation of DSBP(DSBPSD),DDBPSD,NSBPSD,and NDBPSD.At the same time,heart rate variability was measured by 24 hours Holter monitor.The ambulatory electrocardiogram was used for calculating normal to normal intervals (SDNN),standard deviation of the averages of R-R internals in all 5-minute segments(SDANN),rate mean square of the differences of successive RR intervals(RMSSD),percentage of RR intervals differing ＞50 ms (PNN50％).The differences of the ambulatory blood pressure parameters or heart rate variability were compared between the two groups.Results The levels of 24-hour SBP,DSBP,and DSBP-SD were higher in the BPH group than in the non-BPH group[(126.03±14.66)mmHg (1 mmHg=0.133 kPa) vs.(118.88 ±10.79) mmHg,(126.97±14.46)mmHg vs.(119.94±11.24)mmHg,(12.52±3.85)mmHg vs.(11.04±2.44)mmHg,all P＜0.05].All the parameters of HRV were significantly different between the two groups [(97.22±38.14)mmHg vs.(119.23±36.16)mmHg、(90.11±34.4)mmHg vs.(107.1144.4)mmHg、(19.11±2.76)mmHg vs.(31.96±21.10)mmHg、(2.31±2.87)％ vs.(5.02±4.88)％,all P＜0.05]Conclusions The BPV and HRV are the important influencing factors for PV in BHP patients.
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ObjectiveTo explore the causes for descending of the serum testosterone (T) in middle-aged and elderly men with metabolic syndrome (MS).MethodsFifty-six male patients aged between 45 and 83 years old were investigated.Blood pressure,height and weight were measured,and body mass index (BMI) was calculated.Biochemical indice in fasting state [ fasting blood sugar (FBG),total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C) ],fasting insulin (FIN),and the level of serum testosterone) were detected.An insulin resistance index (IR) was calculated using homeostasis model assessment (HOMA).Participants were divided into the MS group and the non-MS group according to CDS diagnostic standard.The relationships between the level of serum Testosterone and each index were analyzed.ResultsThe level of serum Testosterone was significantly lower in the MS group than that in the non-MS group [ (9.97 ± 3.87 ) nmol/L vs.( 13.73 ± 3.93 ) nmol/L,t =3.337,P ＜ 0.01 ].Multiple regression analysis showed that the level of serum testooterone was negatively correlated with age,waist circumference and HOMA-IR ( regression coefficients:- 0.214,- 0.329,- 0.317; standardized regression coefficients:- 0.730,- 0.597,- 0.313 ; t =- 5.833,- 4.681,- 2.686 respctively; P ＜ 0.01 ).ConclusionThe level of serum testosterone descends in middle-aged and elderly men with MS.The level of serum testosterone is closely related to age,waist circumference and insulin resistance
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Objective To investigate the correlation between brain natriuretic peptide(BNP)and left ventricular diastolic function in the elderly patients with diabetes mellitus and hypertension.Methods 128 elderly patients with diabetes mellitus were divided into diabetes without hypertension (n=63)and with hypertension(n=65),and other 62 normal subjects were selected as control group.Plasma BNP levels and indexes of echocardiography,including left ventricular mass index(LVMI),the mitral peak flow velocity during early(E)and late diastole(A),ratio of E/A,average peak velocities at mitral annuluses of six sites in left ventricular wall during early(MEm)and late diastole (MAm),and relative E/MEm were measured in all patients.Results LVMI,E/MEm and the levels of BNP were significantly higher in groups of diabetes without and with hypertension[(91.6 ±17.3)g/m2 and(116.7±20.5)g/m2,(10.3±1.8)and(12.5±1.4),(47.7±29.4)ng/L and(105.7±32.5)ng/L]than in control group[(78.7±19.5)g/m2,(8.9± 1.6)and(20.8±11.63)ng/L,respectively](F=11.54,13.83 and 9.75,all P＜0.05),while MEm in two diabetes groups[(6.8±1.0)and(5.4±0.9)cm/s]were decreased as compared with control group[(8.0± 1.1)cm/s,F=11.26,P＜0.05].The BNP levels were negatively correlated with E/A and MEm(r =-0.42 and -0.51,all P＜0.01),and positively correlated with LVMI and E/MEm(r=0.48 and 0.58,all P＜0.01).Conclusions Left ventricular diastolic function is impaired in diabetes mellitus and more severely impaired in diabetic patients with hypertension.A combination of plasma BNP and echocardiography parameter may be helpful to accurately evaluate left ventricular diastolic function in the elderly patients with diabetes mellitus and hypertension.
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ObjectiveTo assess the left ventricular systolic and diastolic function in patients with type 2 diabetes mellitus(DM) using quantitative tissue velocity imaging(QTVI) ,and to provide reliable evidence for early diagnosis and prevention in diabetic cardiomyopathy.MethodsOne hundred and twenty one type 2 DM patients were divided into two DM 1 groups (61 patients without microangiopathy) and DM2 group (60 patientswith microangiopathy).Fifty normal subjects were enrolled as control group.The index of echocardiography,including the LVEF, FS and mitral peak flow velocity during early and late diastole (E/A) were measured by conventional echocardiography,and the ratio of E/A was calculated.The average peak velocities of six LV wall sites at mitral annuluses during systole, early and late diastole(MEm, MEm, MAm) were measured by QTVI, and the ratio of MEm/MAm was calculated.Results Compared with the normal group, MSm ([7.13 ± 1.42])cm/s vs.([6.49 ± 1.29]cm/s), MEm ([6.22 ± 1.39]cm/s) vs.([4.53 ± 0.94]cm/s) and MEm/MAm ([0.79 ±0.17]vs.[0.59 ± 0.19]) in DM patients were significantly decreased(F = 5.32,8.01 ,4.89 ; Ps ＜0.05).There was no significant differences among three groups in the comparisons of LVEF ([67.45 ±5.47]％),([65.91 ±4.83]％),([68.01 ±6.16]％) and FS([38.84±4.23]％,[37.82±5.43]％),([40.17 ± 4.53]％)(F = 1.89 and 2.46 respectively, P ＞ 0.05) .In addition, E/A of DM2 group (0.71 ±0.21)decreased more dramatically than DM1 and normal (0.91 ± 0.18,1.02 ± 0.24)(F = 4.71, P ＜ 0.05)ConclusionCompared with EF,FS and E/A obtained by conventional echocardiography,QTVI-derived MSm,MEm and MEm/MAm are more sensitive indexes to defect early LV dysfunction.The functional disorder appears early than microangiopathy, and the left ventricular systolic and diastolic function gets worse along with the microangiopathy.
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Objective To investigate the clinical values of brain natriuretic peptide (BNP) in combination with TDI in diagnosing left ventricular hypertrophy (LVH) and impaired diastolic function in elderly hypertensive patients. Methods The 140 elderly hypertensive patients were divided into LVH group (n=69) and NLVH group (n=71). Control group consisted of 50 normal subjects. Plasma BNP level and index of echocardiography, including mitral peak flow velocity during early and late diastole (E, A), ratio of E/A, average peak velocities of six LV wall sites at mitral annuluses during early and late diastole (MEm, MAm), ratios of MEm/MAm and E/MEm were measured in all patients. The correlation of plasma BNP level with cardiac ultrasonographic findings was also examined. Results The level of BNP [(61.64±37.18)ng/L, (138. 65±30. 23)ng/L] and the ratio of E/MEm (11.3±1.83, 15.7±1.45) were significantly higher in NLVH group and LVH group than in normal group (P＜0. 05 or P＜0. 01). MEm [(6.32±0. 94)cm/s, (4.29±0. 91)cm/s]and MEm/MAm (0.76±0.19, 0.51±0. 11) were significantly lower in NLVH and LVH group than in normal group (P＜0.05 or P＜0. 01). The BNP level was negatively correlated with E/A, MEm and MEm/MAm (r=- 0. 294, r= 0. 387 and r= 0. 422, all P＜0. 01), and was positively correlated with LVMI and E/MEm (r=0.342, r=0.501, all P＜0.01). Conclusions Left ventricular diastolic function is impaired in elderly hypertension patients regardless of LVH or NLVH.Plasma BNP level in combination with echocardiography parameter is accurate to evaluate the LVHand impaired diastolic function in elderly hypertensive patients.
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objective To evaluate the relationship between the pulse pressure and the cardiac geometric structure in patients with essential hypertension. Methods Three hundred and ninety-five patients,age ranging from 20 to 77 years,were enrolled into the study. Their clinical systolic and diastolic blood pressure (SBP/DBP) were all above 140/90mmHg. All the patients either were initially diagnosed as having essential hypertension,or confirmed after taking a the placebo for 2 weeks after stopping anti-hypertensive drugs. The cardiac geometric structure was determined by the echocardiography at the same time when the patients untook the 24 hours ambulatory blood pressure monitoring. Results The clinical pulse pressure was significantly different among the groups as divided by the age ( P
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Objective To evaluate the relationship between the carotid atheroscalerosis and coronary artery disease. Methods High frequency ultrasonography was used to examine the carotid artery in seventy two patients who had undergone coronary artery angiography because of acute myocardiac infarction, angina or chest pain. They were divided a group with normal coronary angiography and another group with coronary artery lesion. The latter group included three subgroups according to the number of coronary artery involved: B1 group, B2 group, and B3 group. Scoring of atherosclerosis of the common carotid artery, internal carotid artery and external carotid artery were made with reference to plaques, the intima media thickness (IMT) and the V max of blood flow of the carotid artery as demonstrated by high frequency ultrasonograply. Results The IMT of the group with coronary lesion was significantly higher than that of the normal group ( P