关键词: 高血压, 射血分数保留性心力衰竭, 动态动脉硬化指数, 心室重构

Abstract: Background　The major pathophysiological mechanism of heart failure with preserved ejection fraction（HFpEF）refers to ventricular diastolic dysfunction caused by ventricular remodeling.Ambulatory arterial stiffness index（AASI）refers to a common clinical indicator，which is closely related to both arteriosclerosis and left ventricular remodeling.But less researches on AASI and HFpEF has appeared yet.Objective　To examine the changes of AASI in patients with hypertension and HFpEF，and explore the correlation of AASI with cardiac functional and ventricular structural indices.Methods　210 patients with hypertension〔including 112 with HFpEF（63 with NYHA class Ⅱ-Ⅲ and 49 with NYHA class Ⅲ-Ⅳ）and 98 without〕 who were admitted into the Cardiovascular Department，the Second Affiliated Hospital of Zhengzhou University from 2018 to 2019 were enrolled.Gender，age，admission systolic and diastolic blood pressures，and heart rate and medication history（use of ACEIs/ARBs，calcium channel blockers，digoxin，mineralocorticoid receptor antagonists，diuretic），serum indices〔serum creatinine（Scr），serum urea nitrogen（SUN），alanine aminotransferase，aspartate aminotransferase，total cholesterol，triglyceride，high- and low-density lipoprotein〕in the fasting venous blood sample taken after admission，and NT-proBNP and cardiac functional and structural indices，such as echocardiography measured left ventricular ejection fraction（LVEF），left ventricular end-diastolic diameter（LVDd），interventricular septal thickness，left ventricular posterior wall thickness，left atrial diameter，and calculated left ventricular mass，left ventricular mass index（LVMI）and AASI were recorded.Pearson correlation analysis was used to explore the correlation of AASI with cardiac function and ventricular structure indices.Results　Hypertensive patients with HFpEF had greater average age，higher average levels of Scr，SUN，NT-proBNP，LVMI，LVDd and AASI，as well as higher rate of using diuretics，but had lower average level of LVEF compared with those without（P<0.05）.Hypertensive patients with HFpEF of NYHA class Ⅰ-Ⅱ had lower average levels of NT-proBNP，LVDd，LVMI and AASI，and higher average level of LVEF than those of NYHA class Ⅲ-Ⅳ（P<0.05）.AASI was positively correlated with NT-proBNP（r=0.434，P<0.001），LVDd（r=0.470，P<0.001）and LVMI（r=0.417，P<0.001），and negatively correlated with LVEF（r=-0.410，P<0.001）in patients with HFpEF and hypertension.Conclusion　The AASI was higher，and was related to the changes of cardiac function and the degree of ventricular remodeling in hypertension patients with HFpEF，which may be caused by HFpEF.

Key words: Hypertension, Heart failure with preserved ejection fraction, Dynamic arteriosclerosis index, Ventricular remodeling