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

Ami Kwon,Sang Hyun Ihm,Chan Seok Park

doi:10.1186/s40885-021-00173-3

Ami Kwon, Sang Hyun Ihm + Show 1 more

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https://doi.org/10.1186/s40885-021-00173-3

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Abstract

BackgroundThe 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).MethodsIn 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.ResultThe 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 ± 2.0 vs. -31.1 ± 2.7, p = 0.045). Similar trends were observed for 3D twist (9.6 ± 6.1 vs. 12.1 ± 4.8, p = 0.011) as well as for 3D torsion (1.23 ± 0.78 vs. 1.49 ± 0.62, p = 0.042). The LV principal strain was decreased in the MBPS group (− 33.9 ± 1.7 vs. -35.5 ± 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).ConclusionThe 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.

Highlights

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)
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 transthoracic echocardiography (TTE) parameters showed no difference
A total of 182 patients was enrolled in this study, after 19 individuals were excluded for the following reasons: seven had insufficient ambulatory blood pressure monitoring (ABPM), six had arrhythmia during an echocardiographic examination, five had Left ventricular ejection fraction (LVEF) less than 50%, and one had a poor echocardiographic window

Summary

Introduction

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). Recent studies have investigated that patients with high normal blood pressure and arterial hypertension have subclinical myocardial dysfunction even before development of overt LVH [13, 14]. Principal strain is a method for describing multi-dimensional deformations that is widely applied in structural change applications [16]. Principal strain is applied well for biologic tissues with an underlying structure of muscle fibers, and strain direction can be related to actual fiber direction Application of these novel strains to myocardial deformation can be useful in characterizing effective LV systolic function and underlying structural changes [17, 18]

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