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The impact of high-normal blood pressure on left ventricular mechanics: a three-dimensional and speckle tracking echocardiography study

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Abstract

To assess the presence of subclinical left ventricular myocardial dysfunction in subjects with high-normal blood pressure (BP) and untreated arterial hypertension, using three-dimensional (3D) echocardiography strain analysis. This cross-sectional study included 49 subjects with optimal BP, 50 subjects with high-normal BP, and 50 newly diagnosed untreated hypertensive patients matched by gender and age. All the subjects underwent 24 h blood pressure monitoring and complete two-dimensional and 3D echocardiography examination. The enrolled subjects were grouped according to 24 h systolic BP values, dividing the subjects with optimal BP from those with high-normal BP and the hypertensive patients (cut-off values were 120 and 130 mmHg, respectively). 3D global longitudinal strain was significantly lower in the high-normal BP group and the hypertensive patients, in comparison with the optimal BP group (−20.5 ± 3.3 vs. −18.7 ± 2.8 vs. −17.6 ± 2.7 %, p < 0.001). Similar results were obtained for 3D global circumferential strain (−18.6 ± 3 vs. −17.1 ± 2.9 vs. −16 ± 2.5 %, p < 0.001), as well for 3D global radial strain (49.4 ± 9.5 vs. 44.7 ± 8.1 vs. 43.5 ± 7.8 %, p = 0.002), and global area strain (−31.2 ± 4.8 vs. −28.7 ± 4.2 vs. −27.1 ± 4.5 %, p < 0.001). LV twist was increased in the hypertensive patients in comparison with the high-normal and the optimal BP groups (10.1° ± 2.4° vs. 10.8° ± 2.6° vs. 13.8° ± 3.1°, p < 0.01), whereas untwisting rate significantly and gradually decreased from the optimal BP group, across the high-normal BP group, to the hypertensive patients (−135 ± 35 vs. −118 ± 31 vs. −102 ± 27°/s, p < 0.001). 3D echocardiography revealed that the subjects with high-normal BP suffered subclinical impairment of LV mechanics similar as the hypertensive patients.

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Authors and Affiliations

  1. University Clinical Hospital Center “Dr. Dragisa Misovic”, Heroja Milana Tepica 1, 11000, Belgrade, Serbia

    Marijana Tadic, Anka Majstorovic, Biljana Pencic, Radisav Scepanovic, Predrag Stevanovic & Vera Celic

  2. Clinic of Cardiology, Clinical Centre of Serbia, Koste Todorovic 8, 11000, Belgrade, Serbia

    Branislava Ivanovic

  3. University Clinical Hospital Center “Zemun”, Vukova 9, 11000, Belgrade, Serbia

    Aleksandar Neskovic

  4. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35123, Padua, Italy

    Luigi Badano

  5. Institute for Medical Statistics and Informatics, Doktora Subotica 15, 11000, Belgrade, Serbia

    Dejana Stanisavljevic

  6. Faculty of Medicine, University of Belgrade, Doktora Subotica 6, 11000, Belgrade, Serbia

    Branislava Ivanovic, Aleksandar Neskovic, Dejana Stanisavljevic, Radisav Scepanovic, Predrag Stevanovic & Vera Celic

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  1. Marijana Tadic
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Correspondence to Marijana Tadic.

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Tadic, M., Majstorovic, A., Pencic, B. et al. The impact of high-normal blood pressure on left ventricular mechanics: a three-dimensional and speckle tracking echocardiography study. Int J Cardiovasc Imaging 30, 699–711 (2014). https://doi.org/10.1007/s10554-014-0382-3

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  • DOI: https://doi.org/10.1007/s10554-014-0382-3

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