Circadian blood pressure pattern and right ventricular and right atrial mechanics: A two- and three-dimensional echocardiographic study |
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| Affiliation: | 1. University Clinical Hospital Center “Dr Dragisa Misovic”, Heroja Milana Tepica 1, 11000 Belgrade, Serbia;2. Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Viale della Resistenza 23, 20036 Meda, Italy;3. Clinical Centre of Serbia, Clinic of Cardiology, Koste Todorovic 8, 11000 Belgrade, Serbia;4. Faculty of Medicine, Doktora Subotica 6, 11000 Belgrade, Serbia;1. Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada;2. University of Chicago Medical Center, Chicago, Illinois;3. King''s College Hospital, London, United Kingdom;1. Department of Hypertension and Nephrology, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil;2. Department of Tele-Electrocardiography, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil;3. Nephrology Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain;4. Department of Echocardiography, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil;5. Department of Nutrition, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil;6. Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden;7. Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden;1. Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, Tokushima, Japan;2. Department of Cardiology, Rawalpindi Medical College, Rawalpindi, Pakistan |
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| Abstract: | The purpose of this investigation was to evaluate right ventricular (RV) and right atrial (RA) function and mechanics in untreated hypertensive patients with different blood pressure (BP) patterns by using two-dimensional (2DE) speckle tracking analyses and three-dimensional echocardiography (3DE). This cross-sectional study included 174 recently diagnosed hypertensive patients. All patients underwent a 24-hour ambulatory BP monitoring and complete 2DE and 3DE examination, including 2DE speckle tracking analysis. Our results showed that 2DE RV global longitudinal strain was significantly lower in the non-dippers. Similar results were obtained for 2DE RV systolic and early diastolic strain rate. The RA longitudinal strain, as well as RA systolic and early diastolic strain rate, was decreased in non-dippers. Our results revealed that 3DE RV end-diastolic and end-systolic volumes were increased, whereas 3DE RV ejection fraction was reduced in non-dipper hypertensive patients. Similar results were obtained for RA volumes and RA ejection fraction estimated by 2DE. Independent predictors of 3DE RV ejection fraction, 2DE RV and RA global longitudinal strain were left ventricular mass index and RV wall thickness. An additional independent predictor of the RV longitudinal strain was 3DE RV ejection fraction, and for RA longitudinal strain, an additional independent predictor was tricuspid E/é ratio. Two-DE speckle tracking evaluation and 3DE examination revealed that the RV and RA function and mechanics were more deteriorated in the non-dipper patients than in dipper untreated hypertensive patients. |
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| Keywords: | Hypertension non-dipping right ventricle right atrium two-dimensional speckle tracking three-dimensional echocardiography |
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