Vasileiadis Konstantinos, Antza Christina, Malliora Anastasia, Potoupni Victoria, Kotsis Vasilios
3rd Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, 56403, Greece.
Vasc Health Risk Manag. 2025 Apr 24;21:269-278. doi: 10.2147/VHRM.S507356. eCollection 2025.
Hypertension significantly impacts cardiovascular health, leading to arterial stiffness and myocardial dysfunction. Pulse wave velocity (PWV) is a recognized measure of arterial stiffness, while cardiac magnetic resonance imaging (MRI) is the gold standard for assessing myocardial structure and function. The aim of the present study is to investigate the relationship between arterial stiffness, ambulatory blood pressure monitoring (ABPM), and cardiac MRI findings in untreated hypertensive individuals.
This cross-sectional study included 22 untreated hypertensive participants referred to the Hypertension ABPM Center of Excellence at Aristotle University of Thessaloniki. Participants underwent carotid-femoral PWV measurement and 24-hour ABPM. Cardiac function and structure were evaluated through cardiac MRI. Statistical analyses included Mann-Whitney and Kruskal-Wallis tests, with logistic regression for associations between c-f PWV and cardiac abnormalities. A significance threshold of p<0.05 was applied.
The study population had increased office and 24-hour ABPM values. Cardiac MRI revealed systolic LV dysfunction in 31.8% and diastolic LV dysfunction in 63.6% of participants. Myocardial fibrosis was present in 50% of the participants. Elevated PWV was significantly associated with LV systolic dysfunction (p=0.003), LV diastolic dysfunction (p=0.002), myocardial stiffness (p<0.001), and myocardial fibrosis (p = 0.004). Additionally, aortic valve velocity was significantly associated with increased arterial stiffness (p=0.006). Post-hoc analysis of fibrosis showed significant differences (p=0.007 for minimal vs no fibrosis; p=0.011 for severe vs no fibrosis).
The study confirms a significant correlation between increased arterial stiffness, systolic ABPM-derived systolic blood pressure, and cardiac MRI dysfunction in untreated hypertensive individuals. These findings highlight the importance of arterial stiffness evaluation as a diagnostic tool for early detection of myocardial dysfunction, allowing for timely intervention and targeted treatment strategies to mitigate heart damage.
高血压对心血管健康有显著影响，会导致动脉僵硬度增加和心肌功能障碍。脉搏波速度（PWV）是公认的动脉僵硬度测量指标，而心脏磁共振成像（MRI）是评估心肌结构和功能的金标准。本研究的目的是调查未经治疗的高血压患者的动脉僵硬度、动态血压监测（ABPM）与心脏MRI结果之间的关系。
这项横断面研究纳入了22名转诊至塞萨洛尼基亚里士多德大学高血压ABPM卓越中心的未经治疗的高血压参与者。参与者接受了颈股PWV测量和24小时ABPM。通过心脏MRI评估心脏功能和结构。统计分析包括Mann-Whitney和Kruskal-Wallis检验，并对颈股PWV与心脏异常之间的关联进行逻辑回归分析。采用p<0.05的显著性阈值。
研究人群的诊室血压和24小时ABPM值均升高。心脏MRI显示，31.8%的参与者存在左心室收缩功能障碍，63.6%的参与者存在左心室舒张功能障碍。50%的参与者存在心肌纤维化。PWV升高与左心室收缩功能障碍（p=0.003）、左心室舒张功能障碍（p=0.002）、心肌僵硬度（p<0.001）和心肌纤维化（p = 0.004）显著相关。此外，主动脉瓣速度与动脉僵硬度增加显著相关（p=0.006）。纤维化的事后分析显示存在显著差异（最小纤维化与无纤维化相比，p=0.007；严重纤维化与无纤维化相比，p=0.011）。
该研究证实了未经治疗的高血压患者动脉僵硬度增加、基于收缩期ABPM得出的收缩压与心脏MRI功能障碍之间存在显著相关性。这些发现凸显了评估动脉僵硬度作为早期检测心肌功能障碍的诊断工具的重要性，有助于及时进行干预并制定针对性治疗策略以减轻心脏损伤。
