Tadic Marijana, Cuspidi Cesare, Pencic-Popovic Biljana, Celic Vera, Mancia Giuseppe
University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Department of Cardiology, Heroja Milana Tepica 1, 11000 Belgrade, Serbia.
University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036 Meda, Italy.
Int J Cardiol. 2017 Sep 15;243:443-448. doi: 10.1016/j.ijcard.2017.06.011. Epub 2017 Jun 6.
The aim of this study was to evaluate left ventricular (LV) mechanics in individuals with daytime, night-time and day-nighttime hypertension.
This cross-sectional study included 272 untreated subjects who underwent 24-hour ambulatory blood pressure monitoring and complete two-dimensional echocardiographic examination including strain analysis. According to current guidelines, night-time hypertension was defined as nocturnal systolic blood pressure≥120mmHg and/or diastolic blood pressure≥70mmHg and day-time hypertension as systolic blood pressure≥135mmHg and/or diastolic blood pressure≥85mmHg.
The study sample included 61 normotensive subjects (22%), 77 isolated daytime hypertension (28%), 40 isolated night-time hypertension (15%) and 94day-nighttime hypertension (35%). LV longitudinal and circumferential strain gradually and significantly decreased from normotensive subjects across patients with isolated daytime and night-time hypertension to hypertensive individuals with persistent hypertension. Radial strain was similar between the observed groups. LV twist increased from normotensive subjects across isolated daytime and night-time hypertensive patients to day-nighttime hypertensive individuals. Hypertensive patients with day-nighttime and night-time hypertension are significantly more associated with decreased longitudinal and circumferential strain than hypertensive patients with isolated day-time hypertension and normotension.
LV mechanics gradually deteriorated from normotensive controls, across isolated day- and night-time hypertension, to day-nighttime hypertension. Patients with night-time and day-nighttime hypertension are associated with higher risk of LV mechanical dysfunction than normotensives and day-time hypertensives.
本研究旨在评估白天、夜间及昼夜高血压患者的左心室（LV）力学情况。
这项横断面研究纳入了272名未经治疗的受试者，他们接受了24小时动态血压监测及包括应变分析在内的完整二维超声心动图检查。根据现行指南，夜间高血压定义为夜间收缩压≥120mmHg和/或舒张压≥70mmHg，白天高血压定义为收缩压≥135mmHg和/或舒张压≥85mmHg。
研究样本包括61名血压正常的受试者（22%）、77名单纯白天高血压患者（28%）、40名单纯夜间高血压患者（15%）和94名昼夜高血压患者（35%）。从血压正常的受试者到单纯白天和夜间高血压患者，再到持续性高血压患者，左心室纵向和圆周应变逐渐且显著降低。各观察组之间的径向应变相似。从血压正常的受试者到单纯白天和夜间高血压患者，再到昼夜高血压患者，左心室扭转增加。与单纯白天高血压患者和血压正常者相比，昼夜高血压和夜间高血压患者的纵向和圆周应变降低更为显著。
从血压正常的对照组，到单纯白天和夜间高血压患者，再到昼夜高血压患者，左心室力学逐渐恶化。与血压正常者和白天高血压患者相比，夜间和昼夜高血压患者发生左心室机械功能障碍的风险更高。
