Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography

• Published in: Clinical hypertension Vol. 27; no. 1; pp. 1 - 9
• Main Authors: Kwon, Ami, Ihm, Sang Hyun, Park, Chan Seok
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 15.08.2021; BioMed Central; BMC; 대한고혈압학회
• Subjects: Ambulatory blood pressure monitoring; Blood pressure; Cardiac arrhythmia; Cardiovascular disease; Comparative analysis; Deformation; Echocardiography; Electrocardiography; Flow velocity; Heart; Hypertension; Laboratories; Left ventricular deformation; Measurement; Medical research; Medicine, Experimental; Sleep; Speckle tracking echocardiography; Statistical analysis; Three dimensional echocardiography; Values; Variance analysis; 내과학
• ISSN: 2056-5909; 1342-2154; 2635-6325; 2056-5909
• DOI: 10.1186/s40885-021-00173-3

Background The aim of this study was to examine left ventricular (LV) function in untreated, newly diagnosed hypertensive patients with morning blood pressure surge (MBPS) status using three-dimensional (3D) speckle tracking echocardiography (STE). Methods In this study, 163 newly diagnosed hypertensive patients were included, and all patients underwent 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM, participants were divided into a MBPS group and a non-MBPS group. The entire study population was examined by complete two-dimensional (2D) transthoracic echocardiography (TTE) and 3D STE. Result The results of this study showed that 3D LV longitudinal strain was significantly decreased in the MBPS group compared with the non-MBPS group (- 30.1 [+ or -] 2.0 vs. -31.1 [+ or -] 2.7, p = 0.045). Similar trends were observed for 3D twist (9.6 [+ or -] 6.1 vs. 12.1 [+ or -] 4.8, p = 0.011) as well as for 3D torsion (1.23 [+ or -] 0.78 vs. 1.49 [+ or -] 0.62, p = 0.042). The LV principal strain was decreased in the MBPS group (- 33.9 [+ or -] 1.7 vs. -35.5 [+ or -] 2.8, p < 0.001). The 3D LV global longitudinal strain (GLS) and principal strain were significantly associated with quartile of MBPS as measured by systolic blood pressure (SBP). Conclusion The 3D STE revealed that LV mechanics were more impaired in the MBPS group than in the non-surge newly diagnosed, untreated hypertensive patients; even the 2D TTE parameters showed no difference. Keywords: Blood pressure, Ambulatory blood pressure monitoring, Three dimensional echocardiography, Speckle tracking echocardiography, Left ventricular deformation