Inclusion Criteria:  1.patients of outpatient clinic 2.65≥Adult aged ≥18years old;  Exclusion Criteria:  The exclusion criteria were patients aged less than 18 or greater than 65 years, previous diagnosis of diabetes mellitus, coronary artery disease, valve heart disease, primary cardiomyopathies, arterial fibrillation, left ventricular ejection fraction<50% , inadequate echocardiographic imaging. The patients with disease leading low PP(≤30mmHg) were special examined and excluded, including pericardial disease, severe mitral stenosis, aortic stenosis, severe chronic heart failure, blood loss and shock etc. A total of 40 patients were exclude from the study according to the preset criteria.