Objective

2

To explore the characteristics of left ventricular structure and function of hypertension patients with different traditional Chinese medicine （TCM） syndromes.

Methods

2

A cross-sectional study of 3030 patients were designed to compare between normotensive group （1824 cases） and hypertensive group （1206 cases）. The hypertensive group was further divided into

yin

deficiency with

yang

hyperactivity syndrome （535 cases）， exuberance of liver fire syndrome （403 cases）， phlegm-dampness congestion syndrome （183 cases） and deficiency of both

yin

and

yang

syndrome （85 cases）. The basic information was collected， and the immediate blood pressure， heart rate， the routine biochemical indicators including blood glucose， triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C） and low-density lipoprotein cholesterol （LDL-C）， the left ventricular structure and function indicators including left ventricular end-diastolic diameter （LVDD）， left ventricular posterior wall thickness （LVPW）， left ventricular ejection fraction （LVEF）， left ventricular mass index （LVMI） and peak early to late diastolic filling velocity （E/A）， as well as global longitudinal strain （GLS） by 2D speckle tracking imaging were measured.

Results

2

Compared to the normotensive subjects， hypertensive patients had a higher proportion of males， older age， greater body mass index （BMI）， waist circumference （WC）， higher systolic blood pressure （SBP）， diastolic blood pressure （DBP）， blood glucose， TG， TC， LDL-C， LVDD， LVPW and LVMI， and decreased E/A， LVEF， GLS and HDL-C （

P

＜0.01）. Among all the TCM syndromes， the deficiency of both

yin

and

yang

syndrome had lowest heart rate and blood glucose. Compared to those in the exuberance of liver fire syndrome group， BMI， WC， SBP and DBP significantly decreased in the

yin

deficiency with

yang

hyperactivity syndrome group； TG was significantly reduced in the deficiency of both

yin

and

yang

syndrome group， and HDL-C significantly increased in the

yin

deficiency with

yang

hyperactivity syndrome group. Compared to those in the phlegm-dampness congestion syndrome group， BMI was reduced in the

yin

deficiency with

yang

hyperactivity syndrome group and the deficiency of both

yin

and

yang

syndrome group； DBP significantly decreased， while age was older in the

yin

deficiency with

yang

hyperactivity syndrome group； and WC was reduced in the deficiency both

yin

and

yang

syndrome group （

P

＜0.05）. Compared to the normotensive subjects， hypertensive patients of all TCM syndromes had significantly larger LVDD， LVPW and LVMI， as well as lower E/A and GLS； moreover， the phlegm-dampness congestion syndrome and the

yin

deficiency with

yang

hyperactivity syndrome had decreased LVEF. Compared to the exuberance of liver fire syndrome and the phlegm-dampness congestion syndrome， decreased LVDD was seen in the

yin

deficiency with

yang

hyperactivity syndrome and the deficiency of both

yin

and

yang

syndrome. LVPW significantly decreased in the

yin

deficiency with

yang

hyperactivity syndrome group compared to that in the exuberance of liver fire syndrome group. Compared to phlegm-dampness congestion syndrome， lower LVPW and LVMI were seen in the

yin

deficiency with

yang

hyperactivity syndrome， while decreased LVPW and increased GLS were seen in the deficiency of both

yin

and

yang

syndrome （

P

＜0.05）.

Conclusion

2

Hypertensive patients have varied abnormal indicators， left ventricular structure and function among different TCM syndromes， and more changes in cardiac structure and early systolic function are seen in the phlegm-dampness congestion syndrome.