WHITE COAT EFFECT LEVEL CORRELATED WITH THE ECHOCARDIOGRAPHIC PARAMETERS AND COMPOSITE ENDPOINT DATA IN TREATED PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Objective: The aim of our study was to determine relationship between echocardiography (Echo) left ventricular mass index (LVMI), composite endpoint data and white coat effect (WCE) level in treated patients with arterial hypertension (AH). Design and method: We nalysed database (treated AH patients (n = 125) with concomitant chronic diseases without exacerbation or in compensation stage). This study was prospective and included three visits every 3 months: 1 visit - screening, ambulatory blood pressure monitoring (ABPM) session, Echo; 2 - assessment of the patient’s status and the therapy effectiveness; 3- assessment of the patient’s status, ABPM session, Echo (the total number of ABPM was 239, Echo - 240). We assessed composite endpoint after 30.1 ± 7.6 months from the screening visit (the primary composite endpoint included death for any reason angina pectoris, transient ischemic attack, development of chronic heart failure, arterial revascularization, frequent ventricular extrasystoles, atrial fibrillation, secondary - deterioration of the cardiovascular diseases course and tertiary endpoint - deterioration of the arterial hypertension, concomitant diseases course). We used ANOVA for statistical analysis. Results: The baseline mean (M ± m) daytime systolic BP (SBP) was 125.1 ± 9.8 and diastolic (DBP) - 76.1 ± 7.0 mm Hg, age was 62.8 ± 9.0 years. We identified a positive correlation between tertiary composite endpoint data and WCE: for systolic WCE (SWCE) (F = 4.7, p < 0.031). We found correlations between WCE and Echo parameters: 1) SWCE level had with LVMI (r = 0.16, p < 0.017); 2) diastolic WCE (DWCE) had negative relationship with end-diastolic (EDD) and systolic (ESD) diameters (r = -0.181, p < 0.007 and r = -0.187, p < 0.005); with ejection fraction (EF) and posterior wall thicknesses (PWT) (r = -0.176, p < 0.008 and r = -0.142, p < 0.033). In addition, we have identified that age and duration of AH were associated with SWCE, height and body mass index (BMI) had negative correlations with DWCE (see table). Thus, SWCE level had positive correlation with tertiary composite endpoint results (F = 4.7, p < 0.031) and LVMI (r = 0.16, p < 0.017). DWCE level had negative relationships with Echo LV contractility indices (ESD, EDD, EF). Conclusions: Thus, only systolic WCE level had correlation with composite endpoint data and LVMI. DWCE level had negative associations with echocardiography LV contractility parameters.