Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Cardiology Department, University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
Am J Cardiol. 2014 Mar 1;113(5):832-9. doi: 10.1016/j.amjcard.2013.11.031. Epub 2013 Dec 12.
The purpose of this study was to investigate left ventricular (LV) mechanics in hypertensive patients by 2- and 3-dimensional (3D) speckle tracking imaging, and determine the relation between the LV mechanics and functional capacity in this population. This cross-sectional study included 51 recently diagnosed, untreated, hypertensive patients, 49 treated subjects with well-controlled arterial hypertension, 52 treated participants with uncontrolled hypertension, and 50 controls adjusted by gender and age. All the subjects underwent 24-hour blood pressure monitoring, complete 2-dimensional and 3D examination, and cardiopulmonary exercise testing. 3D global longitudinal, circumferential, radial, and area strains were similar between the control group and well-controlled hypertensive patients but significantly decreased in comparison with patients with untreated or inadequately controlled hypertension. Similar findings were obtained for LV torsion and twist rate, whereas LV untwisting rate significantly deteriorated from the controls, across the well-controlled group, to the patients with untreated or uncontrolled hypertension. Peak oxygen uptake was significantly lower in the patients with untreated and uncontrolled hypertension than in the controls and the well-treated hypertensive patients. Peak oxygen uptake was independently associated with LV untwisting rate (β = 0.28, p = 0.03), 3D LV ejection fraction (β = 0.31, p = 0.024), and 3D global longitudinal strain (β = 0.26, p = 0.037) in the whole hypertensive population in our study. In conclusion, LV mechanics and functional capacity are significantly impaired in the patients with uncontrolled and untreated hypertension in comparison with the controls and the well-controlled hypertensive patients. Functional capacity is independently associated with 3D global longitudinal strain, LV untwisting rate, and 3D LV ejection fraction.
本研究旨在通过二维（2D）和三维（3D）斑点追踪成像研究高血压患者的左心室（LV）力学，并确定该人群的 LV 力学与功能能力之间的关系。这项横断面研究纳入了 51 例新近诊断且未经治疗的高血压患者、49 例血压控制良好的治疗患者、52 例血压控制不佳的治疗患者以及 50 例经性别和年龄校正的对照组。所有受试者均接受 24 小时血压监测、完整的 2D 和 3D 检查以及心肺运动试验。3D 整体纵向、周向、径向和面积应变在对照组和血压控制良好的高血压患者之间相似，但与未经治疗或血压控制不佳的高血压患者相比明显降低。LV 扭转和扭转率也得到了类似的发现，而 LV 解旋率从对照组到血压控制良好的组再到未经治疗或血压控制不佳的患者显著恶化。未经治疗和血压控制不佳的高血压患者的峰值摄氧量明显低于对照组和血压良好控制的高血压患者。峰值摄氧量与 LV 解旋率（β=0.28，p=0.03）、3D LV 射血分数（β=0.31，p=0.024）和 3D 整体纵向应变（β=0.26，p=0.037）在我们研究中的整个高血压人群中独立相关。总之，与对照组和血压控制良好的高血压患者相比，未经治疗和血压控制不佳的高血压患者的 LV 力学和功能能力明显受损。功能能力与 3D 整体纵向应变、LV 解旋率和 3D LV 射血分数独立相关。
