Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital , Istanbul , Turkey .
Clin Exp Hypertens. 2014;36(8):572-8. doi: 10.3109/10641963.2014.881844. Epub 2014 Feb 3.
Abstract Objectives: To evaluate subclinical left ventricular and right ventricular systolic impairment in dipper and non-dipper hypertensives by using isovolumic acceleration.
About 45 normotensive healthy volunteers (20 men, mean age 43 ± 9 years), 45 dipper (27 men, mean age 45 ± 9 years) and 45 non-dipper (25 men, 47 ± 7 years) hypertensives were enrolled. Isovolumic acceleration was measured by dividing the peak myocardial isovolumic contraction velocity by isovolumic acceleration time.
Non-dippers indicated lower left ventricular (2.2 ± 0.4 m/s(2) versus 2.8 ± 1.0 m/s(2), p < 0.01) and right ventricular isovolumic acceleration values (2.8 ± 0.8 m/s(2) versus 3.5 ± 1.0 m/s(2), p = 0.012) compared with dippers. Left ventricular mass index (p = 0.001), interventricular septal thickness (p = 0.002) and myocardial performance index (p < 0.001) were negatively correlated with left ventricular isovolumic acceleration. Left ventricular septal thickness (p = 0.002), mass index (p = 0.001) and right ventricular myocardial performance index (p < 0.001) were negatively correlated with right ventricular isovolumic acceleration.
The present study demonstrates that non-dipper hypertensives have increased left and right ventricular subclinical systolic dysfunction compared with dippers. Isovolumic acceleration is the only echocardiographic parameter in predicting this subtle impairment.
通过等容加速度评估杓型和非杓型高血压患者亚临床左、右心室收缩功能障碍。
共纳入 45 名血压正常的健康志愿者（20 名男性，平均年龄 43±9 岁）、45 名杓型高血压患者（27 名男性，平均年龄 45±9 岁）和 45 名非杓型高血压患者（25 名男性，47±7 岁）。等容加速度通过将峰值心肌等容收缩速度除以等容加速度时间来测量。
非杓型高血压患者的左心室（2.2±0.4m/s²与 2.8±1.0m/s²，p<0.01）和右心室等容加速度值（2.8±0.8m/s²与 3.5±1.0m/s²，p=0.012）均低于杓型高血压患者。左心室质量指数（p=0.001）、室间隔厚度（p=0.002）和心肌做功指数（p<0.001）与左心室等容加速度呈负相关。室间隔厚度（p=0.002）、质量指数（p=0.001）和右心室心肌做功指数（p<0.001）与右心室等容加速度呈负相关。
本研究表明，与杓型高血压患者相比，非杓型高血压患者存在左、右心室亚临床收缩功能障碍。等容加速度是唯一可预测这种隐匿性损害的超声心动图参数。
