Diagnostic value of echocardiography combined with angiotensin Ⅱ for hypertensive heart disease

Zhou Boya; Huang Shiying; Chen Wenwei; Wu Darong

doi:10.3760/j.issn.1673-4777.2019.12.005

Abstract：Objective To analyze the value of combined echocardiography and serum angiotensin Ⅱ(Ang Ⅱ)detection in the diagnosis of hypertensive heart disease.Methods From January to December 2017,100 patients with hypertensive heart disease admitted to the Eighth Affiliated Hospital (Shenzhen Futian),Sun Yat-Sen University were enrolled as observation group;100 healthy people were enrolled as control group.Echocardiography was performed and the level of serum AngⅡ was detected in all subjects.Diagnostic efficiency of different means for hypertensive heart disease was analyzed using receiver operating characteristic(ROC) curve.Results Patients in the observation group showed abnormal echocardiogram parameters such as left atrial diameter,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular mass,lefi ventricular ejection fraction and fractional shortening as compared with the control group(all P ＜ 0.05).Among patients with different grades of hypertension there were significant differences in the proportions of left atrial dilatation[14.6％ (6/41) for grade 1 vs 56.8％ (25/44) for grade 2 vs 93.3％ (14/15) for grade 3] and aortic atherosclerosis[29.3％ (12/41) for grade 1 vs 47.7％ (21/44) for grade 2 vs 46.7％ (7/15) for grade 3] (all P ＜0.05).Serum level of AngⅡ in the observation group was significantly higher than that in the control group [(44 ± 7)ng/L vs (26 ± 5)ng/L] (P ＜0.001).Combining serum AngⅡ and echocardiography showed a larger area under ROC curve than separate diagnosis (0.869 vs 0.706,0.744;both P ＜0.001).Diagnostic sensitivity of combined detection(92.0％) was significantly higher than that of separate methods (P ＜ 0.001).Diagnostic specificity was 71.0％ and the accuracy was 83.0％.Positive and negative predictive values of combined detection were more than 80％.Conclusion Echocardiography combined with serum AngⅡ can improve the diagnostic sensitivity for hypertensive heart disease.