The relationship between left ventricular diastolic function and the autonomic nervous function in elderly patients with mild-to-moderate essential hypertension

Abstract

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.