Department of Cardiology, University Clinical Hospital Center "Dr. Dragisa Misovic - Dedinje", Belgrade, 11000, Serbia.
Faculty of Medicine, Institute for Rehabilitation, University of Belgrade, Belgrade, Serbia.
High Blood Press Cardiovasc Prev. 2024 Nov;31(6):631-638. doi: 10.1007/s40292-024-00674-w. Epub 2024 Oct 1.
Previous studies showed the importance of right ventricular (RV) remodeling in patients with arterial hypertension and RV longitudinal strain was recognized as very sensitive parameter for detection of subtle cardiac impairment. However, its clinical importance in arterial hypertension has not been established so far.
The present study aimed to evaluate the association between RV longitudinal strain (global and free-wall) on adverse outcomes measured by MACE in the large group of hypertensive patients who were followed for mean period of 10 years.
This retrospective study finally included 544 hypertensive patients who underwent full echocardiographic examination including 2D speckle tracking imaging. between January 2010 and December 2014. MACE was considered as the primary outcome and it was defined by all-cause mortality, cardiovascular mortality, myocardial infarction, coronary artery by-pass, coronary stent implantation, stroke, development of heart failure, and occurrence of atrial fibrillation during follow-up.
Patients who experienced MACE were older than those who did not. There was no difference in demographic and clinical parameters between MACE and non-MACE patients. There was no difference in RV diameter, but MACE patients had higher RV wall thickness. RV systolic function parameters were similar between the two groups. RV global and free-wall longitudinal strain were significantly lower in MACE patients (-22.3 ± 3.6 vs. -24.7 ± 3.9%, p < 0.001 and - 25.8 ± 4.2 vs. -28.1 ± 4.5%, p < 0.001; respectively). Reduced RV GLS [OR 1.10; 95%: 1.02-1.20] and reduced RV free-wall longitudinal strain [OR 1,21; 95%CI: 1.05-1.39] were independently of clinical and echocardiographic parameters related with adverse outcome measured by MACE.
RV GLS and RV free-wall longitudinal strain were independently related with adverse outcomes during 10-year follow-up in initially uncomplicated hypertensive patients.
先前的研究表明，右心室（RV）重构在动脉高血压患者中非常重要，而 RV 纵向应变被认为是检测心脏细微损伤的非常敏感的参数。然而，其在动脉高血压中的临床重要性尚未得到确定。
本研究旨在评估在随访平均 10 年的大组高血压患者中，RV 纵向应变（整体和游离壁）与主要不良心血管事件（MACE）测量的不良结局之间的相关性。
这项回顾性研究最终纳入了 544 名高血压患者，他们在 2010 年 1 月至 2014 年 12 月期间接受了完整的超声心动图检查，包括 2D 斑点追踪成像。MACE 被认为是主要结局，它被定义为全因死亡率、心血管死亡率、心肌梗死、冠状动脉旁路移植术、冠状动脉支架植入术、中风、心力衰竭的发展以及随访期间心房颤动的发生。
发生 MACE 的患者比未发生 MACE 的患者年龄更大。在 MACE 和非 MACE 患者之间，人口统计学和临床参数没有差异。RV 直径没有差异，但 MACE 患者的 RV 壁厚度更高。两组 RV 收缩功能参数相似。MACE 患者的 RV 整体和游离壁纵向应变明显较低（-22.3±3.6%比-24.7±3.9%，p<0.001 和-25.8±4.2%比-28.1±4.5%，p<0.001）。RV GLS 降低[比值比 1.10；95%可信区间：1.02-1.20]和 RV 游离壁纵向应变降低[比值比 1.21；95%可信区间：1.05-1.39]与临床和超声心动图参数独立相关，并与 MACE 测量的不良结局相关。
在最初无并发症的高血压患者中，RV GLS 和 RV 游离壁纵向应变与 10 年随访期间的不良结局独立相关。
