Key result
Left ventricular diastolic dysfunction in elderly patients with mild-to-moderate essential hypertension was associated with significantly impaired autonomic nervous function, including reduced SDNN.
Cross-Sectional (n=146)
No
Absolute Event Rate: 81.3% vs 114.9%
p-value: p=<.05
In elderly patients with mild-to-moderate essential hypertension, left ventricular diastolic dysfunction is significantly associated with impaired autonomic nervous function, as evidenced by reduced heart rate variability.
Hypothesis-generating in elderly hypertensives; prospective studies needed before any clinical consideration.
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.
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Liu et al. (2018) conducted a cross-sectional in Mild-to-moderate essential hypertension (n=146). Left ventricular diastolic dysfunction vs. Normal left ventricular diastolic function was evaluated on Standard deviation of all RR intervals (SDNN) (p=<.05). Left ventricular diastolic dysfunction in elderly patients with mild-to-moderate essential hypertension was associated with significantly impaired autonomic nervous function, including reduced SDNN.
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