The impact of high-normal blood pressure on left ventricular mechanics: a three-dimensional and speckle tracking echocardiography study.
To assess the presence of subclinical left ventricular myocardial dysfunction in subjects with high-normal blood pressure (BP) and untreated arterial hypertension, using three-dimensional (3D) echocardiography strain analysis. This cross-sectional study included 49 subjects with optimal BP, 50 subjects with high-normal BP, and 50 newly diagnosed untreated hypertensive patients matched by gender and age. All the subjects underwent 24 h blood pressure monitoring and complete two-dimensional and 3D echocardiography examination. The enrolled subjects were grouped according to 24 h systolic BP values, dividing the subjects with optimal BP from those with high-normal BP and the hypertensive patients (cut-off values were 120 and 130 mmHg, respectively). 3D global longitudinal strain was significantly lower in the high-normal BP group and the hypertensive patients, in comparison with the optimal BP group (-20.5 ± 3.3 vs. -18.7 ± 2.8 vs. -17.6 ± 2.7%, p < 0.001). Similar results were obtained for 3D global circumferential strain (-18.6 ± 3 vs. -17.1 ± 2.9 vs. -16 ± 2.5 %, p < 0.001), as well for 3D global radial strain (49.4 ± 9.5 vs. 44.7 ± 8.1 vs. 43.5 ± 7.8%, p = 0.002), and global area strain (-31.2 ± 4.8 vs. -28.7 ± 4.2 vs. -27.1 ± 4.5%, p < 0.001). LV twist was increased in the hypertensive patients in comparison with the high-normal and the optimal BP groups (10.1° ± 2.4° vs. 10.8° ± 2.6° vs. 13.8° ± 3.1°, p < 0.01), whereas untwisting rate significantly and gradually decreased from the optimal BP group, across the high-normal BP group, to the hypertensive patients (-135 ± 35 vs. -118 ± 31 vs. -102 ± 27°/s, p < 0.001). 3D echocardiography revealed that the subjects with high-normal BP suffered subclinical impairment of LV mechanics similar as the hypertensive patients.
University Clinical Hospital Center "Dr. Dragisa Misovic", Heroja Milana Tepica 1, 11000, Belgrade, Serbia, marijana_tadic@hotmail.com.
Marijana
M
Tadic
Anka
A
Majstorovic
Biljana
B
Pencic
Branislava
B
Ivanovic
Aleksandar
A
Neskovic
Luigi
L
Badano
Dejana
D
Stanisavljevic
Radisav
R
Scepanovic
Predrag
P
Stevanovic
Vera
V
Celic
D000328:Adult; D058070:Asymptomatic Diseases; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016277:Ventricular Function, Left