The Department of Cardiology, Asahi University Hospital, 3-23 Hashimoto-cho, Gifu, 500-8523, Japan.
Gifu Prefectural General Medical Center, Gifu, Japan.
Heart Vessels. 2021 Jun;36(6):827-835. doi: 10.1007/s00380-020-01751-5. Epub 2021 Jan 19.
Visit-to-visit variability in systolic blood pressure (VVV-SBP) has been associated with increased cardiac events. Hence, volume analysis by two-dimensional speckle-tracking echocardiography (2-DSTE) allows physicians to easily measure phasic left atrial (LA) function. However, the relationship of VVV-SBP and functional deformation of the left atrium with patients' clinical outcome is unclear. The aim of the study was to investigate the relationship between phasic LA function and VVV-SBP. The subjects were 70 male participants in whom 2-DSTE was performed to measure blood pressure at health check-ups every year for 5 years. The standard deviation of systolic blood pressure (SBP) was calculated to assess VVV-SBP. The average SBP (Ave-SBP) was also assessed. Total emptying function (EF) (reservoir function), passive EF (conduit function), and active EF (booster pump function) of the left atrium were calculated to evaluate phasic LA function by 2-DSTE. The Pearson correlation, simple regression analysis, and multivariate logistic regression analysis were used in data analysis. Participants' mean age was 50 ± 10 years, and 16 participants had hypertension. VVV-SBP correlated with total EF (r = - 0.30, p = 0.014) and active EF (r = - 0.35, p = 0.003). There was no correlation between the standard deviation of SBP and passive EF (r = - 0.10, p = 0.39). Ave-SBP had no significant relationship with total EF (r = - 0.06, p = 0.62), passive EF (r = - 0.08, p = 0.50), or active EF (r = - 0.03, p = 0.78). Active EF was also associated with VVV-SBP in multiple regression analysis. The active EF was significantly decreased in the highest quartile of VVV-SBP. Despite the small sample size of our study, the VVV-SBP showed a relationship with the phasic LA function. Our findings suggest that high VVV-SBP is noted to be associated with cardiovascular risk including a deterioration of LA function in clinical practice.
血压变异性与心脏事件有关。因此,二维斑点追踪超声心动图(2-DSTE)的容量分析可以使医生轻松测量左心房(LA)的相位功能。然而,VVV-SBP 与左心房功能变形与患者临床结果的关系尚不清楚。本研究旨在探讨左心房相位功能与 VVV-SBP 的关系。研究对象为 70 名男性参与者,他们在健康检查中每年接受 2-DSTE 测量血压,为期 5 年。计算收缩压(SBP)的标准差以评估 VVV-SBP。还评估了平均 SBP(Ave-SBP)。通过 2-DSTE 计算左心房的总排空功能(储器功能)、被动排空功能(导管功能)和主动排空功能(助推泵功能),以评估左心房的相位功能。数据分析采用 Pearson 相关、简单回归分析和多元逻辑回归分析。参与者的平均年龄为 50±10 岁,16 人患有高血压。VVV-SBP 与总 EF(r=-0.30,p=0.014)和主动 EF(r=-0.35,p=0.003)相关。SBP 标准差与被动 EF 无相关性(r=-0.10,p=0.39)。Ave-SBP 与总 EF(r=-0.06,p=0.62)、被动 EF(r=-0.08,p=0.50)或主动 EF(r=-0.03,p=0.78)均无显著关系。多回归分析也显示主动 EF 与 VVV-SBP 相关。VVV-SBP 最高四分位数的主动 EF 明显降低。尽管我们的研究样本量较小,但 VVV-SBP 与左心房相位功能之间存在关系。我们的研究结果表明,在临床实践中,高 VVV-SBP 与心血管风险相关,包括左心房功能恶化。