Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography

Ami Kwon; Sang Hyun Ihm; Chan Seok Park

doi:10.1186/s40885-021-00173-3

Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography

Clin Hypertens. 2021 Aug 15;27(1):16. doi: 10.1186/s40885-021-00173-3.

Authors

Ami Kwon¹, Sang Hyun Ihm², Chan Seok Park³

Affiliations

¹ Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul, Seoul, Republic of Korea.
² Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul, Seoul, Republic of Korea.
³ Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul, Seoul, Republic of Korea. chanseok2002@gmail.com.

Abstract

Background: The aim of this study was to examine left ventricular (LV) function in untreated, newly diagnosed hypertensive patients with morning blood pressure surge (MBPS) status using three-dimensional (3D) speckle tracking echocardiography (STE).

Methods: In this study, 163 newly diagnosed hypertensive patients were included, and all patients underwent 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM, participants were divided into a MBPS group and a non-MBPS group. The entire study population was examined by complete two-dimensional (2D) transthoracic echocardiography (TTE) and 3D STE.

Result: The results of this study showed that 3D LV longitudinal strain was significantly decreased in the MBPS group compared with the non-MBPS group (- 30.1 ± 2.0 vs. -31.1 ± 2.7, p = 0.045). Similar trends were observed for 3D twist (9.6 ± 6.1 vs. 12.1 ± 4.8, p = 0.011) as well as for 3D torsion (1.23 ± 0.78 vs. 1.49 ± 0.62, p = 0.042). The LV principal strain was decreased in the MBPS group (- 33.9 ± 1.7 vs. -35.5 ± 2.8, p < 0.001). The 3D LV global longitudinal strain (GLS) and principal strain were significantly associated with quartile of MBPS as measured by systolic blood pressure (SBP).

Conclusion: The 3D STE revealed that LV mechanics were more impaired in the MBPS group than in the non-surge newly diagnosed, untreated hypertensive patients; even the 2D TTE parameters showed no difference.

Keywords: Ambulatory blood pressure monitoring; Blood pressure; Left ventricular deformation; Speckle tracking echocardiography; Three dimensional echocardiography.