Marijana Tadic1, Cesare Cuspidi2, Vera Celic1, Biljana Pencic-Popovic1, Giuseppe Mancia3. 1. Department of Cardiology, University Clinical Hospital Center 'Dr Dragisa Misovic - Dedinje', Belgrade, Serbia. 2. Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda. 3. University of Milan-Bicocca and Istituto Auxologico Italiano, Piazza dell'Ateneo, Milano, Italy.
Abstract
BACKGROUND: We sought to investigate right ventricular (RV) and right atrial mechanics in patients with daytime, night-time and daytime-night-time hypertension. METHODS: This cross-sectional study included 256 untreated patients who underwent 24-h ambulatory blood pressure monitoring and complete echocardiographic examination including strain analysis. Night-time hypertension was defined as nocturnal SBP at least 120 mmHg and/or DBP at least 70 mmHg and daytime hypertension as SBP at least 135 mmHg and/or DBP at least 85 mmHg. RESULTS: RV structure, diastolic function and global longitudinal RV strain in patients with nocturnal hypertension are intermediate between daytime and daytime-night-time hypertension. On the other side, RV systolic and diastolic strain rates referring to the RV free wall are significantly deteriorated in the patients with nocturnal and daytime-night-time hypertension in comparison with normotension and daytime hypertension. Right atrial conduit function is significantly reduced in the patients with nocturnal and day-night-time hypertension comparing with other two groups, whereas right atrial reservoir and pump functions are intermediate between daytime and daytime-night-time hypertension. A 24-h SBP is independently of other clinical and echocardiographic parameters associated with RV and right atrial global strain. CONCLUSION: RV mechanics is worse in night-time and daytime-night-time hypertensive patients than in normotensive controls and isolated daytime hypertensive patients. A 24-h SBP is independently associated with right heart mechanics.
BACKGROUND: We sought to investigate right ventricular (RV) and right atrial mechanics in patients with daytime, night-time and daytime-night-time hypertension. METHODS: This cross-sectional study included 256 untreated patients who underwent 24-h ambulatory blood pressure monitoring and complete echocardiographic examination including strain analysis. Night-time hypertension was defined as nocturnal SBP at least 120 mmHg and/or DBP at least 70 mmHg and daytime hypertension as SBP at least 135 mmHg and/or DBP at least 85 mmHg. RESULTS: RV structure, diastolic function and global longitudinal RV strain in patients with nocturnal hypertension are intermediate between daytime and daytime-night-time hypertension. On the other side, RV systolic and diastolic strain rates referring to the RV free wall are significantly deteriorated in the patients with nocturnal and daytime-night-time hypertension in comparison with normotension and daytime hypertension. Right atrial conduit function is significantly reduced in the patients with nocturnal and day-night-time hypertension comparing with other two groups, whereas right atrial reservoir and pump functions are intermediate between daytime and daytime-night-time hypertension. A 24-h SBP is independently of other clinical and echocardiographic parameters associated with RV and right atrial global strain. CONCLUSION: RV mechanics is worse in night-time and daytime-night-time hypertensivepatients than in normotensive controls and isolated daytime hypertensivepatients. A 24-h SBP is independently associated with right heart mechanics.