title: High-normal blood pressure, functional capacity and left heart mechanics: is there any connection?
abstract: OBJECTIVE
  To evaluate the relationship between functional capacity and left ventricular (LV) and left atrial (LA) myocardial deformation, assessed by two- and three-dimensional (2DE and 3DE) strain analysis, in subjects with high-normal blood pressure (BP).
  
  
  METHODS
  This cross-sectional study included 64 subjects with optimal BP and 75 subjects with high-normal BP of similar gender and age. All the subjects underwent a complete 2DE and 3DE examination and cardiopulmonary exercise testing.
  
  
  RESULTS
  3DE global longitudinal strain was significantly lower in the group with high-normal BP than in the optimal BP group (- 20.1 ± 2.4 vs - 18.5 ± 2.3%, p < 0.001). Similar results were obtained for 3DE global circumferential strain (- 21.8 ± 2.6 vs - 19.3 ± 2.4%, p < 0.001), as well as for 3DE global radial strain (45.1 ± 8.8 vs 42.3 ± 7.2%, p = 0.042), and 3DE global area strain (- 30.1 ± 4.2 vs - 28.1 ± 3.8%, p < 0.001). LV twist was similar between the observed groups, whereas untwisting rate was significantly decreased in the subjects with high-normal BP (- 123 ± 30 vs - 112 ± 26°/s, p = 0.023). Peak VO2 was significantly lower in the high-normal BP group (30.8 ± 4 vs 28.3 ± 3.7 ml/kg/min, p < 0.001). 2DE LV ejection fraction (β = 0.38, p = 0.014), 2DE global longitudinal strain (β = 0.35, p = 0.019) and 3DE global longitudinal strain (β = 0.27, p = 0.042) were independently associated with peak VO2.
  
  
  CONCLUSIONS
  LV and LA mechanics, as well as functional capacity are significantly impaired in the subjects with high-normal BP. LV and LA myocardial deformations are associated with peak oxygen uptake.
authors.affiliation: University Clinical Hospital Center "Dr Dragisa Misovic" , Heroja Milana Tepica 1, 11000 Belgrade , Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Sladjana
authors.initials: S
authors.lastname: Backovic
authors.forename: Milena
authors.initials: M
authors.lastname: Kleut
authors.forename: Branislava
authors.initials: B
authors.lastname: Ivanovic
authors.forename: Radisav
authors.initials: R
authors.lastname: Scepanovic
authors.forename: Olinka
authors.initials: O
authors.lastname: Iracek
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D016277:Ventricular Function, Left
keywords: Functional capacity; high-normal blood pressure; left atrium; left ventricle; speckle tracking echocardiography