Microalbuminuria is associated with reduced cardiac cyclic variation of integrated backscatter signal in severe hypertension.
OBJECTIVE
Microalbuminuria (MA) as a marker of systemic vascular disease and left ventricular (LV) hypertrophy is associated with increased cardiovascular mortality and morbidity in patients with essential hypertension. The aim of this study was to investigate changes in cardiac cycle-dependent variation of integrated backscatter signals (CVIBS) in hypertensive patients with MA.


METHODS
Randomly selected 60 hypertensive patients (mean age 51 +/- 8) with uncontrolled blood pressure (BP) (>/=130 mmHg systolic and/or 85 mmHg diastolic) were included. All patients underwent urinary albumin excretion (UAE) measurements, 24-hour ambulatory BP monitoring, and LV echocardiographic examination. UAE was measured in two separate 24-hour urine collection and mean of two values was taken into consideration. Normotensive 20 healthy subjects served as controls. CVIBS values were obtained from mid-anteroseptal, mid-posterolateral, and mid-inferior areas at the papillary muscle level in the parasternal short-axis view. CVIBS was defined as the difference in integrated backscatter values between systole and diastole. CVIBS values in MA positive patients were compared with the values in MA negative patients and control subjects.


RESULTS
Twelve patients had MA (UAE 30 to 300 mg/day) while 48 patients had normal UAE (<30 mg/day). The wall thickness (at septum and posterior) and left ventricular mass index (LVMI) values were all significantly higher in hypertensive patients with MA (P < 0.01). The CVIBS values in MA positive group were significantly lower than the CVIBS values both in MA negative hypertensive patients and control subjects (P < 0.01).


CONCLUSIONS
This study demonstrates that in hypertensive patients a high LVMI is associated with reduced CVIBS values and MA appears to be a marker of hypertrophy.
Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey. ceyhunceyhan@yahoo.com
Ceyhun
C
Ceyhan
Harun
H
Akar
Tarkan
T
Tekten
Alper O
AO
Onbasili
Aslihan
A
Karul
Berent
B
Discigil
Selim
S
Unal
Banu
B
Ozturk
D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology*; D015415:Biomarkers / Q000652:urine; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012709:Serum Albumin / Q000378:metabolism; D013223:Statistics as Topic
D015415:Biomarkers; D012709:Serum Albumin