Göksülük Hüseyin, Habibova Ulvin, Ongun Aydan, Akbulut Müge, Özyüncü Nil, Kürklü Türkan Seda Tan, Erol Cetin
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Echocardiography. 2017 May;34(5):668-675. doi: 10.1111/echo.13516. Epub 2017 Mar 19.
Nondipping blood pressure pattern carry a high risk of cardiovascular and cerebrovascular complications due to a higher cumulative pressure overload. We aimed to define the role of strain analysis for detecting subclinical left ventricular systolic dysfunction in recently diagnosed nondipper and dipper hypertensive patients with normal left ventricular systolic function.
Study population consisted of two groups of patients, Group 1: 45 dipper patients and Group 2: 43 nondipper patients. Global and segmental two-dimensional longitudinal strain analysis were measured by speckle tracking method.
The analysis of two-dimensional left ventricular global longitudinal strain and strain rates showed that there was a significant difference between groups (-18.1%±3.1% for nondippers vs -20.5%±2.4% for dippers, P<.001 for global longitudinal strain and -1.2±0.2 1/s for nondippers vs -1.31±0.16 1/s for dippers, P<.001 for global longitudinal strain rate). The nighttime systolic, diastolic, and mean blood pressure measurements were significantly higher in the nondipper group. Nocturnal dipping rates were statistically different between the groups (P<.001). Interventricular septum, posterior wall thickness, relative wall thickness, left atrial dimension, left ventricular mass, and mass index were higher in the nondipper group. Multivariate analysis demonstrated left atrium size, nocturnal dipping rate, daytime mean blood pressure, and nighttime systolic, diastolic, and mean blood pressure as independent predictors of global longitudinal strain.
In our study, two-dimensional speckle tracking examination showed that the left ventricular systolic function is impaired even in the subclinical period in recently diagnosed nondipper hypertensive patients with deformational analysis.
非勺型血压模式由于累积压力过载更高，具有较高的心血管和脑血管并发症风险。我们旨在确定应变分析在检测近期诊断的左心室收缩功能正常的非勺型和勺型高血压患者亚临床左心室收缩功能障碍中的作用。
研究人群包括两组患者，第1组：45名勺型患者；第2组：43名非勺型患者。通过斑点追踪法测量整体和节段二维纵向应变分析。
二维左心室整体纵向应变和应变率分析显示，两组之间存在显著差异（非勺型患者为-18.1%±3.1%，勺型患者为-20.5%±2.4%，整体纵向应变P<.001；非勺型患者为-1.2±0.2 1/s，勺型患者为-1.31±0.16 1/s，整体纵向应变率P<.001）。非勺型组夜间收缩压、舒张压和平均血压测量值显著更高。两组夜间勺型率在统计学上存在差异（P<.001）。非勺型组的室间隔、后壁厚度、相对壁厚度、左心房内径、左心室质量和质量指数更高。多变量分析表明，左心房大小、夜间勺型率、日间平均血压以及夜间收缩压、舒张压和平均血压是整体纵向应变的独立预测因素。
在我们的研究中，二维斑点追踪检查显示，即使在近期诊断的非勺型高血压患者的亚临床期，通过变形分析也可发现左心室收缩功能受损。
