Yilmaz Samet, Nar Gökay, Til Aysen, Kaftan Asuman
Cardiology Department, Pamukkale University Faculty of Medicine.
Public Health Department, Pamukkale University Faculty of Medicine, Denizli, Turkey.
Blood Press Monit. 2020 Jun;25(3):121-125. doi: 10.1097/MBP.0000000000000440.
In this study, we evaluated the association between morning blood pressure surge (MBPS) levels and diastolic function parameters in patients with masked hypertension (MH).
A total of 92 patients with diagnosis of MH were enrolled in the study. Patients were divided into three groups according to their MBPS levels. Cardiac dimensions, left atrial volume and ejection fraction were determined by transthoracic echocardiography. A two-dimensional Doppler echocardiogram was performed to evaluate diastolic function parameters including transmitral E-wave and A-wave velocity, mitral annular E' and A' velocity, E wave deceleration time and isovolumic relaxation time.
Mean MBPS value of the total study population was 25.1 ± 6.4 mmHg. When going from the lowest MBPS group to the higher MBPS groups; E velocity [0.75 (0.74-0.77) vs. 0.71 (0.69-0.73) vs. 0.68 (0.66-0.69) cm/s, respectively] E/A ratio [1.44 (1.40-1.48) vs. 1.35 (1.32-1.39) vs. 1.26 (1.23-1.29), respectively] and E' velocity [0.114 (0.111-0.117) vs. 0.102 (0.100-0.105) vs. 0.093 (0.089-0.096) cm/s, respectively] were significantly decreased. E/E' ratio [7.3 (6.9-7.7) vs. 6.6 (6.4-7.9), P = 0.002] and left atrial volume index [27.24 (25.5-28.9) vs. 21.90 (21.0-22.7) ml/m, P < 0.001] were significantly higher in the highest MBPS tertile than the lowest tertile. There was a positive correlation between E/E' ratio and MBPS values (r = 0.306, P = 0.003).
Increased MBPS levels were found to be related with deterioration of diastolic function parameters in patients with MH.
在本研究中，我们评估了隐匿性高血压（MH）患者的晨峰血压（MBPS）水平与舒张功能参数之间的关联。
共有92例诊断为MH的患者纳入本研究。根据MBPS水平将患者分为三组。通过经胸超声心动图测定心脏尺寸、左心房容积和射血分数。进行二维多普勒超声心动图检查以评估舒张功能参数，包括二尖瓣E波和A波速度、二尖瓣环E'和A'速度、E波减速时间和等容舒张时间。
研究总人群的平均MBPS值为25.1±6.4 mmHg。从最低MBPS组到较高MBPS组，E速度[分别为0.75（0.74 - 0.77）、0.71（0.69 - 0.73）和0.68（0.66 - 0.69）cm/s]、E/A比值[分别为1.44（1.40 - 1.48）、1.35（1.32 - 1.39）和1.26（1.23 - 1.29）]以及E'速度[分别为0.114（0.111 - 0.117）、0.102（0.100 - 0.105）和0.093（0.089 - 0.096）cm/s]均显著降低。最高MBPS三分位数组的E/E'比值[7.3（6.9 - 7.7）对6.6（6.4 - 7.9），P = 0.002]和左心房容积指数[27.24（25.5 - 28.9）对²¹.⁹⁰（21.0 - 22.7）ml/m²，P < 0.001]显著高于最低三分位数组。E/E'比值与MBPS值之间存在正相关（r = 0.306，P = 0.003）。
发现MBPS水平升高与MH患者舒张功能参数恶化有关。
