Farag El-Sayed M, Al-Daydamony Mohammad M, Gad Marwa M
Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
J Am Soc Hypertens. 2017 Mar;11(3):158-164. doi: 10.1016/j.jash.2017.01.004. Epub 2017 Jan 28.
Heart failure (HF) is a major health problem. Hypertension is an important cause of HF. Most hypertensive patients have some degree of left ventricular (LV) diastolic dysfunction. The 6-minute walk test (6MWT) provides objective data about the exercise tolerance. We aimed to find the association between the degree of LV diastolic dysfunction and the functional capacity assessed by 6MWT in hypertensive patients. The study included 200 asymptomatic hypertensive patients. All patients had undergone full history taking, complete clinical examination, electrocardiography, echocardiography for assessment of LV dimensions, systolic and diastolic dysfunction, and 6MWT. Patients were classified into two groups according to the presence or absence of LV diastolic dysfunction. Clinical and echocardiographic data were comparable between the two groups. Regarding 6MWT, at the end of the test, patients with diastolic dysfunction had significantly higher systolic (P = .0088) and diastolic (P = .019) blood pressure and higher Borg score for dyspnea (P < .00001). The distant walked and percentage of the distance to predicted value were significantly lower in patients with diastolic dysfunction (P = .0322 and .0002, respectively). Incidence of abnormal 6MWT was significantly higher in patients with diastolic dysfunction (P = .00041). Compared to patients with grades I and II, patients with grade III diastolic dysfunction had significantly higher Borg score (P = .013), lower distance walked (P = .039), and lower percentage of distance to predicted vale (P = .009). Independent predictors for abnormal 6MWT were as follows: E/E' ≥15 (P = .0022), E'/A' <1 (P = .0081), and deceleration time of E-wave <160 (P = .013). The presence of LV diastolic dysfunction in hypertensive patients has a bad effect on 6MWT. The degree of LV diastolic dysfunction was correlated with 6MWT results. It may be important to investigate LV diastolic function in asymptomatic hypertensive patients.
心力衰竭（HF）是一个主要的健康问题。高血压是HF的一个重要病因。大多数高血压患者存在一定程度的左心室（LV）舒张功能障碍。6分钟步行试验（6MWT）可提供有关运动耐力的客观数据。我们旨在找出高血压患者LV舒张功能障碍程度与通过6MWT评估的功能能力之间的关联。该研究纳入了200例无症状高血压患者。所有患者均进行了全面的病史采集、完整的临床检查、心电图检查、超声心动图检查以评估LV大小、收缩和舒张功能障碍，以及6MWT。根据是否存在LV舒张功能障碍将患者分为两组。两组之间的临床和超声心动图数据具有可比性。关于6MWT，在试验结束时，舒张功能障碍患者的收缩压（P = 0.0088）和舒张压（P = 0.019）显著更高，呼吸困难的Borg评分也更高（P < 0.00001）。舒张功能障碍患者行走的距离和距离预测值的百分比显著更低（分别为P = 0.0322和0.0002）。舒张功能障碍患者6MWT异常的发生率显著更高（P = 0.00041）。与I级和II级患者相比，III级舒张功能障碍患者的Borg评分显著更高（P = 0.013），行走距离更低（P = 0.039），距离预测值的百分比更低（P = 0.009）。6MWT异常的独立预测因素如下：E/E'≥15（P = 0.0022），E'/A'<1（P = 0.0081），以及E波减速时间<160（P = 0.013）。高血压患者LV舒张功能障碍的存在对6MWT有不良影响。LV舒张功能障碍的程度与6MWT结果相关。在无症状高血压患者中研究LV舒张功能可能很重要。
