Tadic Marijana, Cuspidi Cesare, Pencic Biljana, Ivanovic Branislava, Scepanovic Radisav, Marjanovic Tamara, Jozika Ljilja, Celic Vera
University Clinical Hospital Center "Dr Dragisa Misovic", Heroja Milana Tepica 1, 11000 Belgrade, Serbia.
Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Viale della Resistenza 23, 20036 Meda, Italy.
J Am Soc Hypertens. 2014 Jan;8(1):45-53. doi: 10.1016/j.jash.2013.07.008. Epub 2013 Sep 7.
The purpose of this investigation was to evaluate right ventricular (RV) and right atrial (RA) function and mechanics in untreated hypertensive patients with different blood pressure (BP) patterns by using two-dimensional (2DE) speckle tracking analyses and three-dimensional echocardiography (3DE). This cross-sectional study included 174 recently diagnosed hypertensive patients. All patients underwent a 24-hour ambulatory BP monitoring and complete 2DE and 3DE examination, including 2DE speckle tracking analysis. Our results showed that 2DE RV global longitudinal strain was significantly lower in the non-dippers. Similar results were obtained for 2DE RV systolic and early diastolic strain rate. The RA longitudinal strain, as well as RA systolic and early diastolic strain rate, was decreased in non-dippers. Our results revealed that 3DE RV end-diastolic and end-systolic volumes were increased, whereas 3DE RV ejection fraction was reduced in non-dipper hypertensive patients. Similar results were obtained for RA volumes and RA ejection fraction estimated by 2DE. Independent predictors of 3DE RV ejection fraction, 2DE RV and RA global longitudinal strain were left ventricular mass index and RV wall thickness. An additional independent predictor of the RV longitudinal strain was 3DE RV ejection fraction, and for RA longitudinal strain, an additional independent predictor was tricuspid E/é ratio. Two-DE speckle tracking evaluation and 3DE examination revealed that the RV and RA function and mechanics were more deteriorated in the non-dipper patients than in dipper untreated hypertensive patients.
本研究的目的是通过二维（2DE）斑点追踪分析和三维超声心动图（3DE）评估未经治疗的不同血压（BP）模式的高血压患者的右心室（RV）和右心房（RA）功能及力学特性。这项横断面研究纳入了174例新诊断的高血压患者。所有患者均接受了24小时动态血压监测以及完整的2DE和3DE检查，包括2DE斑点追踪分析。我们的结果显示，非勺型血压患者的2DE RV整体纵向应变显著降低。2DE RV收缩期和舒张早期应变率也得到了类似结果。非勺型血压患者的RA纵向应变以及RA收缩期和舒张早期应变率均降低。我们的结果显示，非勺型高血压患者的3DE RV舒张末期和收缩末期容积增加，而3DE RV射血分数降低。通过2DE评估的RA容积和RA射血分数也得到了类似结果。3DE RV射血分数、2DE RV和RA整体纵向应变的独立预测因素是左心室质量指数和RV壁厚度。RV纵向应变的另一个独立预测因素是3DE RV射血分数，而对于RA纵向应变，另一个独立预测因素是三尖瓣E/A比值。二维斑点追踪评估和三维检查显示，非勺型血压患者的RV和RA功能及力学特性比勺型血压的未经治疗的高血压患者更差。
