Marijana Tadic1, Cesare Cuspidi, Biljana Pencic, Ljilja Jozika, Vera Celic. 1. aUniversity Clinical Hospital Center 'Dr Dragisa Misovic - Dedinje', Department of Cardiology, Heroja Milana Tepica, Belgrade, Serbia bUniversity of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza, Meda, Italy cFaculty of Medicine, Doktora Subotica, Belgrade, Serbia.
Abstract
OBJECTIVE: We aimed at evaluating right ventricular remodeling (structure, function, and mechanics) and heart rate variability (HRV), as well as their interaction, in untreated hypertensive patients. METHOD: This cross-sectional study involved 55 untreated hypertensive patients and 40 patients with no risk factors, similar by sex and age. All the patients underwent a 24-h Holter monitoring and comprehensive two-dimensional and three-dimensional echocardiography assessment (2DE and 3DE). RESULTS: All time and frequency domain HRV variables were reduced in the hypertensive patients. Right ventricular systolic and diastolic function, as well as right ventricular longitudinal strain, was significantly impaired in the hypertensive patients. Parameters that indicate comprehensive right ventricular remodeling (right ventricular wall thickness, tricuspid E/e' ratio, 2DE right ventricular longitudinal strain, and 3D right ventricular ejection fraction) correlated with the parameters of cardiac sympathovagal balance (SD of all normal RR intervals, root mean square of the difference between the coupling intervals of adjacent RR intervals, 24-h low-frequency domain, 24-h high-frequency domain, and 24-h total power). Of note, right ventricular diastolic function, right ventricular longitudinal function, and 3DE right ventricular ejection fraction were associated with cardiac autonomic nervous function, independently of age, BMI, blood pressure, and left ventricular hypertrophy. CONCLUSIONS: Right ventricular structure, systolic and diastolic function, as well as right ventricular longitudinal deformation, are significantly impaired in untreated hypertensive patients. HRV variables are also decreased in hypertensive population. 2DE and 3DE parameters resembling right ventricular remodeling are independently associated with cardiac autonomic nervous system markers in the whole study population.
OBJECTIVE: We aimed at evaluating right ventricular remodeling (structure, function, and mechanics) and heart rate variability (HRV), as well as their interaction, in untreated hypertensivepatients. METHOD: This cross-sectional study involved 55 untreated hypertensivepatients and 40 patients with no risk factors, similar by sex and age. All the patients underwent a 24-h Holter monitoring and comprehensive two-dimensional and three-dimensional echocardiography assessment (2DE and 3DE). RESULTS: All time and frequency domain HRV variables were reduced in the hypertensivepatients. Right ventricular systolic and diastolic function, as well as right ventricular longitudinal strain, was significantly impaired in the hypertensivepatients. Parameters that indicate comprehensive right ventricular remodeling (right ventricular wall thickness, tricuspid E/e' ratio, 2DE right ventricular longitudinal strain, and 3D right ventricular ejection fraction) correlated with the parameters of cardiac sympathovagal balance (SD of all normal RR intervals, root mean square of the difference between the coupling intervals of adjacent RR intervals, 24-h low-frequency domain, 24-h high-frequency domain, and 24-h total power). Of note, right ventricular diastolic function, right ventricular longitudinal function, and 3DE right ventricular ejection fraction were associated with cardiac autonomic nervous function, independently of age, BMI, blood pressure, and left ventricular hypertrophy. CONCLUSIONS: Right ventricular structure, systolic and diastolic function, as well as right ventricular longitudinal deformation, are significantly impaired in untreated hypertensivepatients. HRV variables are also decreased in hypertensive population. 2DE and 3DE parameters resembling right ventricular remodeling are independently associated with cardiac autonomic nervous system markers in the whole study population.