Objective To explore the situation of impaired cardiac microcirculatory perfusion,left ventricular remodeling and myocardial fibrosis in patients with essential hypertension(abbreviated as hypertension)and their clinical significance.Methods Eighty patients with hypertension were selected as hypertension group,and another 80 healthy individuals who underwent physical examina-tions during the same period were selected as control group.Based on the severity of hypertension,patients in the hypertension group were divided into low-risk group and moderate-to-high-risk group.The indicators of impaired cardiac microcirculatory perfusion[left ventricular myocardial blood flow(MBF),right ventricular MBF,coronary flowreserve(CFR)],left ventricular remodeling[left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)]and myocardial fibrosis[left ventricular isovolumic relaxation time(IVRT),the ratio of the peak velocity of E wave to A wave in the diastolic blood flow spectrum of the mitral valve orifice(E/A),type Ⅰ procollagen carboxy-terminal peptide(P Ⅰ CP),type Ⅲprocollagen amino-terminal peptide(PC Ⅲ)]were compared between the control group and the hy-pertension group.Pearson's correlation coefficient method was used for correlation analysis.The differences in the above-mentioned indicators among different risk groups were compared.Receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic efficacy of impaired cardiac microcirculatory perfusion,left ventricular remodeling and myocardial fibrosis for the severity of hypertension.Results In the hypertension group,left ventricular MBF,right ventricular MBF and CFR were all lower than those in the control group,LVEDV and LVESV were larger than those in the control group,LVEF was lower than that in the control group,IVRT was longer than that in the control group,the levels of P Ⅰ CP and PC Ⅲ were higher than those in the control group,and E/A was lower than that in the control group(P＜0.05).The results of Pearson's correlation coef-ficient analysis showed that LVEF was positively correlated with CFR and E/A,and negatively cor-related with IVRT and PC Ⅲ;LVEDV was positively correlated with CFR,IVRT,P Ⅰ CP and PCⅢ;LVESV was positively correlated with IVRT,P Ⅰ CP and PC Ⅲ,and negatively correlated with E/A;left ventricular MBF was positively correlated with CFR and E/A,and negatively correlated with IVRT,P Ⅰ CP and PC Ⅲ;right ventricular MBF was positively correlated with CFR and E/A,and negatively correlated with IVRT,P Ⅰ CP and PC Ⅲ.In the moderate-to-high-risk group,IVRT was longer than that in the low-risk group,LVEDV was larger than that in the low-risk group,P ⅠCP,PC Ⅲ,E/A,LVEF,left ventricular MBF,right ventricular MBF and CFR were all lower than those in the low-risk group,and LVESV was smaller than that in the low-risk group,with statistical-ly significant differences(P＜0.05).The results of ROC curve analysis showed that the areas under the curves for diagnosing the severity of hypertension by impaired cardiac microcirculatory perfusion,left ventricular remodeling and myocardial fibrosis were 0.962,0.969 and 0.945 respectively,the sensitivities were 91.4％,97.1％and 88.6％respectively,and the specificities were 95.6％,88.9％and 93.3％respectively.Conclusion Hypertension can cause impaired cardiac microcirculatory perfusion and promote the processes of left ventricular remodeling and myocardial fibrosis.Impaired cardiac microcirculatory perfusion,left ventricular remodeling and myocardial fibrosis have good di-agnostic efficacy for the severity of hypertension.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.

Objective:To explore the effect of the hyperbaric oxygen therapy combined with percutaneous coronary intervention (PCI) on blood rheological properties in patients with unstable angina and its protective effect on myocardial injury.Methods:A total of 168 cases of patients with unstable angina admitted to Department of Cardiovascular Medicine of the First Affiliated Hospital of Henan University from June 2017 to December 2018 were selected as research subjects and divided into control group (84 cases) and observation group (84 cases). The control group was given conventional PCI, and symptomatic and supportive treatment, while the observation group were given hyperbaric oxygen therapy (1 time/day, 10 days constitute one treatment course, 2 courses in total) on the basis of the treatments in the control group. The clinical efficacy was compared between the two groups. The changes in blood rheological indexes and myocardial injury markers of the patients were detected before and after treatment.Results:In the observation group, there were 45 cases with markedly efficacy, and 34 cases showed some efficacy. The total effective rate was 94.05%, which was significantly higher than that of 84.52% in the control group. The difference was statistically significant ( P<0.05). After treatment, the PaO 2 of the patients in the observation group significantly increased, while the PaCO 2 significantly decreased. The improvement of the blood oxygen metabolism was more significant than that in the control group ( P<0.05). Meanwhile, the levels of blood rheological indexes, e. g. whole blood viscosity (ηb), erythrocyte sedimentation rate (ESR), hematocrit (HCT), erythrocyte electrophoresis time (EET), erythrocyte aggregation index (EAI), and platelet aggregation rate (PAgT), in the two groups all declined obviously, and those in the observation group had greater decline than those in the control group ( P<0.05). The lysophospholipids acid (LPA) and platelet-activating factor P-selectin (CD62P) in the two groups significantly decreased, and the levels of LPA and CD62P in the observation group had greater decreases than those in the control group ( P<0.05). Moreover, the levels of the markers of myocardial injury, e. g. cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) in both groups increased significantly, and the cTnI and CK-MB levels in the observation group were significantly lower than those in the control group. Conclusion:Through increasing blood oxygen content in body tissues, hyperbaric oxygen can effectively reduce blood viscosity, improve blood rheological properties, and therefore, reduce platelet activation, thus preventing thrombosis. It can also reduce myocardial injury and enhance the clinical efficacy for patients with unstable angina.