University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Clinic for Internal Medicine, Cardiology Department, 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.
Hypertens Res. 2021 Dec;44(12):1625-1632. doi: 10.1038/s41440-021-00768-1. Epub 2021 Oct 1.
We aimed to investigate short- and long-term blood-pressure (BP) variability and left-ventricular (LV) structure, function, and mechanics in women with gestational hypertension and preeclampsia, as well as the relationship between BP variability and LV mechanics. This cross-sectional study included 140 pregnant women (45 normotensive controls, 50 patients with gestational hypertension and, 45 patients with preeclampsia) after 20 weeks of gestation. All participants underwent 24-h ambulatory BP monitoring and echocardiographic examination, as well as regular clinical BP measurements during each visit. Our results show that 24-h, daytime and nighttime systolic and diastolic BP, as well as visit-to-visit systolic and diastolic BPs, gradually increased from controls across patients with preeclampsia to those with gestational hypertension. Similar changes were observed for 24-h systolic BP-variability indices. LV longitudinal and circumferential strains gradually decreased from controls across women with gestational hypertension to patients with preeclampsia. Radial strain was significantly lower in women with preeclampsia than in controls. Indices of short- and long-term BP variability were independent of BP and demographic and echocardiographic parameters associated with LV longitudinal and circumferential strain. In conclusion, LV mechanics are impaired in women with gestational hypertension and preeclampsia compared with LV mechanics in normotensive controls. Short- and long-term BP variability was higher in patients with hypertensive disorders and was significantly associated with longitudinal and circumferential strains.
我们旨在研究妊娠高血压和子痫前期妇女的短期和长期血压（BP）变异性以及左心室（LV）结构、功能和力学特性，以及 BP 变异性与 LV 力学之间的关系。这项横断面研究纳入了 140 名孕妇（45 名血压正常对照者、50 名妊娠高血压患者和 45 名子痫前期患者），均在妊娠 20 周后进行。所有参与者均接受了 24 小时动态血压监测和超声心动图检查，并在每次就诊时进行常规临床血压测量。我们的研究结果显示，24 小时、白天和夜间收缩压和舒张压以及就诊间收缩压和舒张压从血压正常对照组逐渐增加到子痫前期患者，收缩压变异性的 24 小时指数也出现了类似的变化。LV 纵向和环向应变从血压正常对照组逐渐降低到妊娠高血压患者，径向应变明显低于血压正常对照组。短期和长期 BP 变异性指数与 BP 以及与 LV 纵向和环向应变相关的人口统计学和超声心动图参数独立。总之，与血压正常对照组相比，妊娠高血压和子痫前期妇女的 LV 力学受损。高血压疾病患者的短期和长期 BP 变异性更高，与纵向和环向应变显著相关。
