Right ventricular dysfunction in early systemic hypertension:   a tissue Doppler imaging study in patients with high-normal   and mildly increased arterial blood pressure.
OBJECTIVE
To analyze the relationship between increasing systemic blood pressure (BP) and right ventricular (RV) function.


METHODS
Ninety-eight never-treated, nonobese patients with BP values varying from the optimal to the mild hypertensive range. Peak early diastolic (Em) and systolic (Sm) velocities were recorded at the tricuspid and mitral annuli by tissue Doppler imaging (TDI); global RV and left ventricular (LV) structure and function by conventional echo-Doppler sonography; insulin sensitivity by homeostasis model assessment (HOMA) index. Data were analyzed by 24-h systolic BP (cut-offs 117 and 130 mmHg), thus partitioning an optimal BP from an intermediate high-normal and an upper mildly increased BP stratum.


RESULTS
Em decreased in the mid-third and decelerated further in association with reduced Sm in the upper BP tertile; both correlated negatively to septal thickness and positively to homologous TDI-derived LV indices. RV and LV indices of global ventricular function, estimated pulmonary pressure, HOMA did not differ by systemic BP.


CONCLUSIONS
RV diastolic and systolic function deteriorates in response to slightly increased systemic BP. The process paralleled homologous changes at the LV side and was driven by interventricular septum remodeling, perhaps as a reflection of its role in RV function and biventricular interdependence. Insulin sensitivity seemed to play no relevant role.
Pedrinelli
Roberto
R
Dipartimento Cardio Toracico e Vascolare & Endocrinologia e Metabolismo, Università di Pisa, Pisa, Italy. r.pedrinelli@med.unipi.it
Canale
Maria Laura
ML
Giannini
Cristina
C
Talini
Enrica
E
Penno
Giuseppe
G
Dell'Omo
Giulia
G
Di Bello
Vitantonio
V
D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018608:Ultrasonography, Doppler