Evaluation of the Effect of Sigmoid-Shaped Interventricular Septum on Left Ventricular Systolic Function in Patients with Essential Hypertension by Two-Dimensional Speckle Tracking Echocardiography

Objective: To evaluate left ventricular regional and global systolic function by measuring left ventricular longitudinal strain (LS) in hypertensive patients with sigmoid-shaped interventricular septum (SIS) by two-dimensional speckle tracking (2D-STE);in order to explore whether the sigmoid-shaped interventricular septum affects the left ventricular systolic function in patients with hypertension. Methods: Routine echocardiographic parameters were measured in 30 hypertensive patients with SIS (SIS group) and 30 hypertensive patients without SIS (non-SIS group). The left ventricular segments and global LS were measured by 2D-STE, and the two sets of parameters were compared. Results: The value of the thickness of the basal segment of the interventricular septum (IVSBT), the thickness of the middle segment of the interventricular septum (IVSMT) and the ratio of the basal segment of the ventricular septum to the middle segment of the interventricular septum (IVSBT/IVSMT) in SIS group was higher than that in non-SIS group. However, the value of left ventricular outflow tract diameter (LVOTD) in SIS group was lower than that in non-SIS group. There was a significant difference between the two groups (all P Conclusion: SIS affects left ventricular regional systolic function of patients with hypertension. 2D-STE can early evaluate left ventricular longitudinal systolic function in hypertensive patients with SIS.

Effect of Bushen Hemai Decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai Decoction on the wall stiffness of middle-aged and elderly patients with isolated systolic hypertension. Methods: A total of 126 patients with middle and old systolic hypertension were selected from March 2017 to March 2018 in our hospital. According to the random table method, there were 63 cases in the observation group and 63 cases in the control group. The control group was treated with conventional western medicine, while the observation group was treated with kidney tonifying and pulse prescription hypothyroidism on the basis of the control group. The two groups were treated for 12 weeks. The changes of blood pressure, pulse conduction velocity and endothelium-dependent vasodilation function were compared between the two groups before and after treatment. Results: the systolic pressure in the two groups was lower than that before the treatment, but the diastolic pressure was not significantly changed, and the systolic pressure in the observation group was lower than that of the control group, while the diastolic pressure was not statistically significant. After treatment, the pulse conduction velocity of the two groups was lower than that before the treatment, and the pulse conduction velocity of the observation group was lower than that of the control group after treatment. After two groups of treatment, FMD was higher than before treatment, but there was no significant change in the diameter of vascular base, and FMD in the observation group was higher than that of the control group, but there was no statistical difference between the blood vessel base diameter. The total effective rate of the observation group (93.65%) was higher than that of the control group (74.60%). Conclusion: Bushen Hemai Decoction is effective in treating isolated systolic hypertension in middle-aged and old patients, and can reduce the stiffness of patients' tube wall, which is worthy of clinical reference.

Effect of Bushen Hemai decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai decoction on the wall stiffness of middle-aged and elderly patients with simple systolic hypertension. Methods: The 126 middle-aged and elderly patients with simple systolic hypertension admitted to our hospital from May 2010 to May 2015 were randomly divided into control group (63 cases) and observation group (63 cases). The control group was treated with conventional Western medicine, while the observation group was treated with Bushen Hemai decoction on the basis of the control group. The two groups were treated for 4 weeks. Results: The systolic blood pressure of the two groups decreased after treatment (observation group: T=16.165, control group: T=13.537, P<0.05);the systolic blood pressure of the two groups did not change significantly after treatment (observation group: T=1.857, control group: T=0.483, P>0.05);the systolic blood pressure of the observation group was lower than that of the control group after treatment (T=16.165, P<0.05). After treatment, the level of ST segment of ECG in the two groups was lower than that before treatment (observation group: T=22.145, control group: T=11.007, P<0.05);after treatment, the level of ST segment of ECG in the observation group was lower than that in the control group (T=8.130, P<0.05). After treatment, the pulse conduction velocity of the two groups was lower than that of the control group (observation group:T=8.694, control group: T=3.944, P<0.05);after treatment, the pulse conduction velocity of the observation group was lower than that of the control group (T=5.326, P<0.05). The total effective rate of the observation group (93.65%) was higher than that of the control group (76.19%) (P<0.05). Conclusion: Bushen Hemai Decoction has a significant clinical effect on middle-aged and elderly patients with simple systolic hypertension, and can improve the stiffness of the tube wall, which is worthy of clinical reference.

Effect of renal denervation for patients with isolated systolic hypertension:a systematic review and meta-analysis

BACKGROUND Renal denervation(RDN)is a promising treatment based on catheter intervention for patients with refractory hypertension.However,the effect in patients with isolated systolic hypertension(ISH)remains controversial.The aim of this meta-analysis was to determine the blood pressure lowing effect of RDN in patients with ISH compared with combined systolic/diastolic hypertension(CH)patients.METHODS PubMed,Embase,Cochrane and ClinicalTrials.gov were searched for prospective clinical studies that included RDN.The outcomes of interest were the change of 24-hour ambulatory systolic blood pressure(SBP)from baseline.We used the fixed effects model to calculate weighted mean difference(WMD)with 95%confidence interval(CI).RESULTS Six trials were included,with 1405 participants,including 597 patients with ISH and 808 patients with CH.Mean follow-up was five months.The reduction of 24-hour ambulatory SBP was significantly greater for the CH patients than the ISH patients(WMD=3.89,95%CI:2.32–5.45,P<0.0001).RDN also showed a greater reduction in office SBP in the CH patients compared to the ISH patients(WMD=10.24,95%CI:4.24–15.74,P=0.0003).And the effect was independent of age,length of follow-up,and ablation device.CONCLUSIONS RDN provides superior blood pressure control in the CH patients compared with the ISH patients,and the CH patients may be the best suitable population for which RDN is indicated.

Adverse Maternal Consequences Associated with Prolonged Acute-Onset Severe Systolic Hypertension during Pregnancy &Early Postpartum: Pitfalls in Practice &Lessons Learned

OBJECTIVE: To determine the types of major maternal-perinatal morbidity associated with prolonged, acute-onset severe systolic hypertension during pregnancy and postpartum. METHODS: A medicolegal database retaining only medical record data was created from all cases involving women with medical/hypertensive disorders of pregnancy evaluated by the first author between 1986-2015. Case files of women that experienced severe systolic hypertension (SSH) sustained for many hours to days were identified for study. RESULTS: Sixty six pregnant/postpartum women met study criteria. Stroke secondary to intracranial hemorrhage or thrombosis (65.2) and acute pulmonary edema (33%) were the leading causes of maternal morbidity and mortality, most often antepartum as a component of early-onset preeclampsia (≤34 weeks). Eclampsia, abruptio placenta and injury to heart, liver and/or kidneys were other frequent co-morbidities. Seven postpartum women developed sudden new-onset postpartum SSH and suffered a stroke 4 - 13 days after delivery. Maternal mortality (54.6%) and morbidity as persistent disability (24.2%) were high in this cohort. CONCLUSION: Failure to rapidly respond, reduce and sustain at a safe level acute-onset SSH poses a significant threat to the wellbeing of mothers and babies, before and in the weeks following delivery. Systems to implement safe practices to identify and emergently treat severe maternal hypertension are needed.

Changes in plasma total bile acid level of patients with essential hyper tension and of spontaneous hypertension rats and the correlation with systolic and diastolic blood pressures

To examine the hypothesis that plasma bile acid (BA) level is correlated with essential hypertension (EH). Methods: The level of plasma total bile acid (TBA) in 88 patients with EH and in 11 spontaneous hypertension rats (SHR) were measured, and regression analysis of systolic and diastolic blood pressures with plasma TBA was performed. Results: Plasma TBA level in EH patients was significantly higher than that in normotensive subjects (7. 35±3. 38μmol/L vs 4. 94±3. 25 μmol/L, PRO. of ); Plasma TBA level in SHR was significantly higher than that in Wistar--Kyoto (WKY) rats (13. 16±3. 58 μmol/L vs 10. 42±2. 24 μmol/L,P<0. 05); Plasma TBA level in patients with EH was the highest in stage Ⅲ (9. 54±4. 12 μmol/L, n ＝25), the lowest in stage Ⅰ (5. 76±3. 33 μmol/L, n＝33), and middle in stage Ⅱ (7. 32±4. 52 μmol/L, n＝30); Plasma TBA level in patients with EH was positively correlated with both systolic (r= 0. 33, P<0. 01 ) and diastolic blood pressure (r＝0. 46, P＜0．01 ); Plasma TBA level in SHR was positively correlated with both systolic (r＝0. 82, P<0. 01 ) and diastolic blood pressures (r＝0. 69, P<0. 01). Conclusion: elevated level of plasma TBA in patients with EH and in SHR may participate in the pathogenesis of hypertension.

Influence of irbesartan combined with low dose urokinase on treatment effect and serologic indexes in elderlyisolated systolic hypertension patients

To study the influence of irbesartan combined with low dose urokinase on treatment effect and serologic indexes in elderly isolated systolic hypertension patients. Methods: One hundred and ten cases of elderly isolated systolic hypertension patients in our hospital during January 2013–January 2016 were randomly divided into observation group with 55 cases and control group with 55 cases. Patients in observation group received irbesartan combined with low dose hydrochlorothiazide treatment and those in control group received amlodipine combined with low dose hydrochlorothiazide treatment, each lasted for 4 weeks. After 4 weeks treatment, non-invasive blood pressure and blood pressure variability indexes were measured, serum endothelial function, inflammatory factors and oxidative stress indexes were measured. Results: After 4 weeks treatment, patients systolic blood pressure (SBP), 24 h mean systolic blood pressure (24 h SBP), 24 h systolic blood pressure standard deviation (24 h SSD) were significantly lower in observation group than in control group (P<0.05);serum endothelial function index EF-1 was lower in observation group than in control group, while NO and endothelial nitric oxide synthase (eNOS) were higher in observation group than in control group (P<0.05);serum high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α (TNF-α) contents were lower in observation group than in control group (P<0.05);serum oxidation index such as malondialdehyde (MDA) was lower in observation group than in control group, while antioxidant indexes such as total anti-oxidative capacity (TAC), superoxide dismutase (SOD), GSH were higher in observation group than in control group (P<0.05). Conclusions: Irbesartan combined with low dose hydrochlorothiazide can effectively reduce systolic hypertension and blood pressure variability in elderly isolated systolic hypertension patients, while optimizing the systemic inflammation and oxidative stress status.

Ultrasound evaluation of left ventricular remodeling and systolic synchrony in patients with primary hypertension and the correlation with serum cytokines and MMPs

Objective:To study the correlation of the ultrasound parameters of left ventricular remodeling and systolic synchrony in patients with primary hypertension with serum cytokines and matrix metalloproteinases (MMPs).Methods:134 patients with primary hypertension receiving three-dimensional echocardiography examination in our hospital between May 2013 and March 2016 were selected and divided into the group A with normal pattern (n=71), group B with concentric hypertrophy (n=39) and group C with eccentric hypertrophy (n=24) according to the left ventricular internal diameter at end-diastole (LVIDd) and left ventricular mass index (LVMI), and the ultrasound parameters of left ventricular remodeling and systolic synchrony as well as serum content of cytokines and MMPs were determined.Results: The time to minimal systolic volume of 16-segmental standard deviation (SDI), maximum time difference (DIF), Tpe, Tpe interphase and its correction (Tpec), LVIDd, LVMI and left ventricular remodeling index (LVRI) of group B and group C were significantly higher than those of group A (P<0.05), and SDI, DIF, Tpe, Tpec, LVIDd, LVMI and LVRI of group C were significantly higher than those of group B (P<0.05);serum tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17), transforming growth factor-β1 (TGF-β1), matrix metalloproteinase 2 (MMP2), MMP3 and MMP9 content of group B and group C were significantly higher than those of group A (P<0.05), and serum TNF-α, IL-17, TGF-β1, MMP2, MMP3 and MMP9 content of group C were significantly higher than those of group B (P<0.05) and positively correlated with LVIDd, LVMI, LVRI, SDI, DIF, Tpe and Tpec;serum TIMP1 and TIMP2 content of group B and group C were significantly lower than those of group A (P<0.05), and serum TIMP1 and TIMP2 content of group C were significantly lower than those of group B (P<0.05) and negatively correlated with LVIDd, LVMI, LVRI, SDI, DIF, Tpe and Tpec.Conclusions:The ultrasound parameters of left ventricular remodeling and systolic synchrony significantly change in patients with primary hypertension and are closely related to the changes in the content of serum cytokines and MMPs.

Single-Arm Clinical Study of Combination Perindopril-Amlodipine Tablets in the Treatment of High-Altitude Hypertension

Objective:To evaluate the efficacy of combination perindopril/amlodipine tablets in patients with high-altitude hypertension who were previously unable to control their blood pressure with monotherapy.Methods:A total of 151 patients with high-altitude hypertension whose blood pressure remained inadequately controlled with previous monotherapy were enrolled in this study.All patients received an 8-week treatment with a combination of perindopril/amlodipine tablets,consisting of perindopril 10 mg/day and amlodipine 5 mg/day.Blood pressure measurements,including both diastolic and systolic pressures,were taken at baseline,and after 2,4,6,and 8 weeks of treatment.Results:After 8 weeks of treatment,there was a significant reduction in both average systolic and diastolic blood pressure compared to baseline(P<0.0001).Specifically,the average systolic blood pressure decreased by 24.45±13.75 mmHg,and the average diastolic blood pressure decreased by 13.37±8.40 mmHg.The overall heart rate showed no significant changes during the treatment period.Conclusion:A combination of perindopril/amlodipine tablets significantly improved blood pressure control in patients with high-altitude hypertension after 8 weeks of treatment.These results support the efficacy of combination perindopril/amlodipine as a viable treatment option for high-altitude hypertension.

王清海教授采用益气化痰法治疗老年ISH患者的经验

(单纯收缩期高血压ISH)是老年常见病、多发病。王清海教授对ISH的诊治有丰富的临床经验,认为ISH应该归属于中医"脉胀"的范畴,ISH是高血压病中的特殊类型,主要见于老年高血压患者,其病机主要为正气虚弱,痰湿阻滞,临床上擅长采用益气化痰法治疗,并研制出用于治疗气虚痰浊型高血压的中药制剂"复方芪麻胶囊"。该药物用于治疗ISH,疗效满意。

用mRNA差异显示法比较SHR和WKY大鼠肾脏组织的基因表达

目的用ｍＲＮＡ差异显示技术观察ＳＨＲ与ＷＫＹ大鼠肾脏组织在ｍＲＮＡ表达水平上的差异。方法取１２周龄的ＳＨＲ及ＷＫＹ大鼠，提取肾脏总ＲＮＡ，用含１２个寡聚核苷酸的Ｔ１１Ａ或Ｔ１１Ｇ引物进行逆转录，用Ｔ１１Ａ、ＡＰ１～３，Ｔ１１Ｇ、ＡＰ６，Ｔ１１Ｇ、ＡＰ７～８引物对逆转录产物进行多聚酶链式反应，反应产物进行聚丙烯酰胺凝胶电泳及放射自显影。结果每一种引物组合在单一电泳泳道上可显示７０～１００条基因表达条带，其中绝大多数代表肾脏基因表达的条带是相同的，但其中显示的４条ＳＨＲ大鼠肾脏基因表达的条带与相对应的ＷＫＹ大鼠肾脏基因表达的条带出现了差异。讨论ｍＲＮＡ差异显示技术对于快速筛选ＳＨＲ及ＷＫＹ大鼠肾脏组织的差异表达基因是适用的。

Determinants of Blood Pressure Variability in Individuals with Essential Hypertension: A Survey-Based Study

Background: Blood pressure variability (BPV) in hypertensive patients is implicated as a remarkable feature leading to additional cardiovascular complications. The aim of the study was to identify the determinants influencing BPV among patients with essential hypertension seen at the Cardiology department of the faculty of medicine, University of Alexandria, Egypt. Methods: This was a descriptive cross-sectional hospital-based study conducted from August 2019 to November 2019. All the eligible patients were made to fill out a standard questionnaire to obtain family and personal clinical history and undergo routine physical examination, laboratory tests and 24-hour ambulatory blood pressure monitoring. BPV was summarized as the standard deviation (SD) of all-day systolic and diastolic BP in both normal patients (with SD 11) and abnormal patients (with SD ≥ 11). Results: Out of a total of 114 patients, 18 (15.8%) non-hypertensive patients were included in the control group and the remaining 96 (84.3%) were classified based on the degree of hypertension. BPV in all these patients was found to be significantly related to the male gender, a mild or moderate degree of hypertension, high prevalence of non-dipping, diabetes, use of beta-blockers as antihypertensive medication, heart rate variability, BMI, and increased day-time variability. Conclusion: Variability in blood pressure influenced by different intrinsic and extrinsic factors plays an important role in the management of hypertension. In order to reduce the burden of disease and for a better quality of life for hypertensive patients, it is important that physicians start considering lowering BPV in addition to reducing physiological BP levels.

缬沙坦与非洛地平治疗老年单纯收缩期高血压(ISH)疗效比较

目的对比缬沙坦和非洛地平对老年单纯收缩期高血压(ISH)患者收缩压的影响。方法将40例患者采用自身交叉对照方法,治疗12周,分为2个药物洗脱期,2个治疗期,洗脱期给予安慰剂(Vitc),治疗期采用随机收服用缬沙坦80mgqd,非洛地平5mgqd。结果在治疗组前后的收缩压有明显下降(P<0.01),缬沙坦与非洛地平血压下降无差异。结论缬沙坦与非洛地平均能降低ISH患者收缩压,疗效相似,副作用少,耐受性好,可以作为老年ISH患者的一线用药长期服用。

乌鲁木齐市不同民族老年ISH患病率及危险因素分析

目的：了解新疆乌鲁木齐市不同民族60岁以上老年人群单纯收缩期高血压（ISH）的患病率，观察ISH患病率与民族、性别、年龄的关系。方法2010年1月~2012年12月采用整群随机抽样方法纳入乌鲁木齐市汉族、维吾尔族和哈萨克族60岁以上老年人3416例，进行心血管疾病患病率横断面调查，统计不同民族、不同性别以及不同年龄人群ISH的患病率。结果共有2957例完成调查，应答率为86.56%（2957/3416）；人群整体ISH患病率为25.50%（754/2957）。按民族比较，汉族、维吾尔族、哈萨克族ISH患病率分别为27.67%（397/1453）、25.00%（260/1040）、20.12%（97/482），3个民族间存在统计差异（χ2=11.01，P＜0.01）；按性别比较，男性患病率为22.89%（356/1555），女性为28.39%（398/1402），女性患病率显著高于男性（χ2=11.72，P＜0.01）；按年龄比较，（61～70）岁、（71～80）岁，80岁以上ISH患病率分别为21.38%（347/1643）、29.56%（295/998）和33.33%（112/336），3个年龄段之间存在统计学差异（χ2=34.01，P＜0.01）。结论新疆乌鲁木齐ISH患病率存在民族、性别差异，且随年龄增加呈增高趋势。

不同运动强度对老年ISH患者有效性及对心脑血管事件安全的影响

目的探讨不同运动强度对老年单纯收缩期高血压(ISH)患者有效性及对心脑血管事件安全的影响。方法选取2018年1月~2019年1月本院收治的单纯收缩压升高高血压者80例,按照随机数字表法分为两组,各40例。对照组实施中等强度运动干预,观察组实施低等强度运动干预。比较两组干预后1个月血管功能相关功能指标,如踝肱指数(ABI)、脉搏波传播速度(PWV)变化,分析干预后两组收缩压、舒张压及平均动脉压变化情况,统计两组干预期间发生相关心脑血管事件,如缺血性脑卒中、脑出血、心肌梗死、心绞痛、心力衰竭等的总比例。结果观察组干预后血管功能相关功能指标中,ABI指数明显高于对照组(P<0.05),PWV显著低于对照组(P<0.05),观察组干预后24h动态血压指标中收缩压、舒张压及平均动脉压显著低于对照组(P<0.05),观察组发生缺血性脑卒中、脑出血、心肌梗死、心绞痛、心力衰竭等的总比例显著低于对照组(P<0.05)。结论针对老年单纯收缩压升高高血压患者实施低等强度的运动干预,可有效改善患者血管功能,调节血压,且安全性较高。

Positive association between triglyceride glucose index and central systolic blood pressure among hypertensive adults

BACKGROUND While studies have suggested the association between triglyceride-glucose(TyG)index,a reliable surrogate for insulin resistance and hypertension data are limited to the correlation of TyG and central blood pressure.This study aims to test the hypothesis that a higher TyG index is associated with elevated central systolic blood pressure(cSBP).METHODS A total of 9249 Chinese hypertensive adults from the H-type Hypertension and Stroke Prevention and Control Project were analyzed in this study.cSBP was measured noninvasively using an A-Pulse CASPro device.TyG index was calculated as ln[fasting triglycerides(mg/dL)×fasting glucose(mg/dL)/2].Smoothing curve and multivariate linear regression models[beta coefficient(β)with 95%CI]were applied to analyze the association between TyG index and cSBP.Subgroup analyses were conducted to explore potential modifications to such a correlation.RESULTS The overall mean TyG index is 8.8±0.7,and the total mean cSBP is 131.3±12.8 mmHg.TyG index was observed to be independently and positively associated with cSBP among the total population(β=0.92,95%CI:0.53–1.31,P<0.001),and participants who do not use antihypertensive drugs(β=1.03,95%CI:0.46–1.60,P<0.001),which is in accordance with the result of the smoothing curve.The association between TyG index and cSBP appears robust in all tested subgroups.CONCLUSIONS TyG index is positively and independently associated with cSBP among hypertensive adults.Our study result suggests that TyG index might serve as an effective marker for vascular function.

Study the effect of exercise on systolic pulmonary artery pressure in healthy subjects

Introduction: As no data is available concerning the cut-off value defining abnormal pulmonary artery systolic pressure (PASP) response in subjects of various ages, the aim of this study is to assess physiological PASP response to exercise in healthy individuals of various ages. Material and methods: One hundred and twenty three healthy volunteers, aged 30 to 70 years, underwent Doppler echocardiographic measurements at rest and after treadmill exercise test. Pulmonary artery systolic pressure was estimated at rest, and immediately after peak exercise using Bernoulli formula (four times tricuspid valve regurgitation velocity squared adding an estimated right atrial pressure). Results: Lower and upper limits of PASP during rest was 7 and 28 mmHg and after peak exercise was 14 and 48 mmHg respectively. After exercise, PASP increased from rest (14 ± 4 mmHg) to peak (25 ± 7 mmHg). Pulmonary artery systolic pressure during rest and peak exercise, increased with age, but has no correlation with body mass index or gender. Conclusion: Pulmonary artery systolic pressure at peak exercise can frequently reach values ≥ 30 mmHg in healthy individuals with good exercise capacity, especially in elderly individuals, which goes beyond pathologic definitions of pulmonary hypertension.

Clinical study about different doses of vardenafil for the treatment of neonatal persistent pulmonary hypertension

Objective: To explore the clinical efficacy of different doses of vardenafil for the treatment of neonatal persistent pulmonary hypertension. Methods: A total of 60 neonates with persistent pulmonary hypertension were diagnosed and treated in this hospital between August 2013 and April 2017, all of them received vardenafil therapy and they were divided into low dose group (2.5 mg), medium dose group (5 mg) and high dose group (10 mg) according to the doses, 20 cases in each group. The differences in pulmonary arterial systolic pressure (PASP) levels as well as the contents of myocardial injury markers and endothelial injury indexes were compared among the three groups of children after 1 month of treatment. Results: After 1 month of treatment, the PASP level in high dose group was lower than that in medium dose group and low dose group;myocardial injury markers hs-cTnT, BNP and LDH contents in peripheral blood were lower than those of medium dose group and low dose group;endothelial injury indexes ET-1 and HIF-1 contents in peripheral blood were lower than those of medium dose group and low dose group whereas ADM and NO contents were higher than those of medium dose group and low dose group. The change trend of the above indicators in medium dose group was greater than that in low dose group. Conclusion: Vardenafil is a reliable drug for clinical treatment of neonatal persistent pulmonary hypertension, and the efficacy is dose-dependent.

Preliminary study of abnormal increase of postexercise systolic blood pressure in the diagnosis of coronary artery disease

Objectives This study sought to evaluate the diagnostic value of abnormal increase of postexercise systolic blood pressure (SBP) for detecting coronary artery disease (CAD) in patients with or without hypertension. Methods Treadmill exercise testing (TET) was conducted in 88 patients (40 CAD patients, 48 control subjects) with or without hypertension, each of whom underwent selective coronary angiography (CAG). The abnormal increase of postexercise SBP was defined as 10mmHg higher than earlier periods during the recovery phase (6 minutes) of exercise testing. Results The abnormal increase of postexercise SBP had higher sensitivity, specificity, and accuracy for detecting CAD than those of ST - segment depression in patients with or without hypertension. Its accuracy increased with the severity of CAD while decreased in patients with hypertension, and the increase value of SBP had a positive correlation with the extent of coronary artery lesion. The combination of ST - segment depression and abnormal increase of postexercise SBP diagnosed CAD most accurately in patients with hypertension. Conclusions Abnormal increase of postexercise SBP may be a useful index for diagnosing CAD.

Ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes

Objective: To discuss the ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes. Methods: A total of 98 late pregnant women with hypertensive disorder complicating pregnancy who were treated in the hospital between December 2014 and February 2017 were selected as hypertensive disorder complicating pregnancy group and 100 normal late pregnant women who received physical examination in the hospital during the same period were selected as normal control group. The ultrasonic parameters of fetal ventricular systolic function in two groups of pregnant women were detected before delivery, and the expression of hypoxia-related genes in placental tissue was detected by fluorescence quantitative PCR. Pearson test was used to assess the correlation between the parameters of fetal ventricular systolic function and placental hypoxia in hypertensive disorder complicating pregnancy. Results: The fetal left ventricular fractional shortening and right ventricular fractional shortening levels of hypertensive disorder complicating pregnancy group were lower than those of normal control group. Angiogenesis-related genes VEGF, netrin-1 and XIAP mRNA expression in placental tissue of hypertensive disorder complicating pregnancy group were lower than those in placental tissue of normal control group while HIF-1α mRNA expression was higher than that in placental tissue of normal control group;oxidative stress-related genes Nrf2, TAC3 and PrxⅡ mRNA expression in placental tissue were lower than those in placental tissue of normal control group;apoptosis genes Fas, p53 and caspase-9 mRNA expression in placental tissue were higher than those in placental tissue of normal control group while Bcl-2 and SFRP2 mRNA expression were lower than those in placental tissue of normal control group. Pearson test showed that the ultrasonic parameter levels of fetal ventricular systolic function in hypertensive disorder complicating pregnancy were directly correlated with the degree of placental hypoxia. Conclusion:Ultrasonic testing of fetal ventricular systolic function in hypertensive disorder complicating pregnancy can be used as a reliable method to measure the degree of placental hypoxia.