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Blood pressure is normal, but is the heart?

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Abstract

Background

There is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients.

Methods

Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, β-blocker, or diuretics.

Results

There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was − 18.70 ± 3.41 versus − 21.01 ± 3.82 (P < 0.001), and global radial strain was 40.6 ± 9.8 versus 54.8 ± 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties.

Conclusions

Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Pediatric Cardiology, Adnan Menderes University, Aydın, Turkey

    Serkan Fazlı Çelik

  2. Faculty of Medicine, Department of Pediatric Cardiology, Inonu University, Malatya, Turkey

    Cemşit Karakurt

  3. Faculty of Medicine, Department of Pediatric Nephrology, Inonu University, Malatya, Turkey

    Yılmaz Tabel & Taner Elmas

  4. Faculty of Medicine, Department of Biostatistics, Inonu University, Malatya, Turkey

    Saim Yoloğlu

Authors
  1. Serkan Fazlı Çelik
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  2. Cemşit Karakurt
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  3. Yılmaz Tabel
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  4. Taner Elmas
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  5. Saim Yoloğlu
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Corresponding author

Correspondence to Serkan Fazlı Çelik.

Ethics declarations

The study was conducted in accordance with the Declaration of Helsinki and was approved by the local ethics committee. The detailed consent forms were signed by the parents of all subjects before participating in the study.

Conflict of interests

The authors declare that there is no conflict of interests regarding the publication of this paper.

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Çelik, S.F., Karakurt, C., Tabel, Y. et al. Blood pressure is normal, but is the heart?. Pediatr Nephrol 33, 1585–1591 (2018). https://doi.org/10.1007/s00467-018-3968-5

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  • DOI: https://doi.org/10.1007/s00467-018-3968-5

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