title: Is there a relationship between right-ventricular and right atrial mechanics and functional capacity in hypertensive patients?
abstract: BACKGROUND
  We sought to assess right-ventricular and right atrial deformation in patients with arterial hypertension by two-dimensional speckle tracking imaging and three-dimensional echocardiography (3DE), and define the relationship between right-ventricular mechanics and exercise capacity in the study population.
  
  
  METHODS
  This cross-sectional study included recently diagnosed untreated hypertensive patients, well controlled hypertensive patients, treated patients with unsatisfactory controlled blood pressure and control individuals adjusted by sex and age. All the patients underwent complete two-dimensional echocardiography and 3DE examination, as well as cardiopulmonary exercise testing.
  
  
  RESULTS
  Right-ventricular strain, and systolic and early diastolic strain rates were significantly decreased in the untreated and the uncontrolled hypertensive patients in comparison with the controls and the well controlled participants. Similar results were obtained for right atrial strain and strain rates. 3DE right-ventricular volumes were increased, whereas 3DE right-ventricular ejection fraction was decreased in the uncontrolled hypertensive patients in comparison with the controls and the well treated patients. Differences in 3DE right-ventricular volumes disappeared after adjustment for body surface area. Considering the whole study population, global right-ventricular strain (β = 0.29, P = 0.018) and 3D right-ventricular stroke volume (β = 0.22, P = 0.041) were independently associated with peak oxygen uptake (VO(2max)) which was significantly decreased in the untreated and the uncontrolled hypertensive patients in comparison with the remaining two groups.
  
  
  CONCLUSIONS
  Our study showed that right-ventricular and right atrial mechanics, as well as exercise capacity, are significantly deteriorated in the hypertensive patients who are untreated or ineffectively treated. Global right-ventricular strain and 3DE right-ventricular stroke volume are independently associated with functional capacity in the whole study population.
authors.affiliation: aUniversity Clinical Hospital Center 'Dr Dragisa Misovic', Heroja Milana Tepica 1, Belgrade, Serbia bUniversity of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Meda, Italy cClinical Centre of Serbia, Clinic of Cardiology, Koste Todorovic 8 dFaculty of Medicine, Doktora Subotica 6, Belgrade, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Jelena
authors.initials: J
authors.lastname: Suzic-Lazic
authors.forename: Anita
authors.initials: A
authors.lastname: Andric
authors.forename: Biljana
authors.initials: B
authors.lastname: Stojcevski
authors.forename: Branislava
authors.initials: B
authors.lastname: Ivanovic
authors.forename: Senada
authors.initials: S
authors.lastname: Hot
authors.forename: Radisav
authors.initials: R
authors.lastname: Scepanovic
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
mesh_terms: D000328:Adult; D000886:Anthropometry; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D004452:Echocardiography; D015444:Exercise; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010100:Oxygen / Q000378:metabolism; D013599:Systole; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
chemical_list: D000959:Antihypertensive Agents; D010100:Oxygen