V.M. Kovalenko, E.G. Nesukay, E.Yu. Titov, N.S. Polenova, О.О. Danylenko.Relation of the ambulatory blood pressure monitoring to myocardial strain and strain rate in patients with essential hypertension

The aim – to examine the relationship between parameters of ambulatory blood pressure monitoring (ABPM), myocardial strain and strain rate in patients with essential hypertension (EH).

Material and methods. We enrolled 71 patients (males – 63.3 %) with stage II hypertension, average age (59.5±2.8) years. According to the ABPM results obtained in 60 patients they were divided into 2 groups. The 1st group consisted of 33 patients with optimal night decrease of systolic blood pressure (SBP) (dippers), the 2nd – 27 patients with insufficient reduction of SBP (non-dippers). Echocardiography study included M-, B-modes, pulse-wave and tissue Doppler, as well as speckle-tracking echocardiography to assess left ventricular (LV) and atrial deformation.

Results and discussion. Patients in the 2nd group, compared to the 1st group, had more common concentric (44.4 % vs. 24.2 %) and eccentric (44.4 % vs 18.2 %) left ventricular hypertrophy (LVH). In addition, patients of the 2nd group had more severe LVH, more left atrium dilatation, more pronounced inhibition of the LV relaxation. Longitudinal strain in this group was less by 17.4 %, strain rate of LV myocardial deformation – by 13.5 %, reservoir and conduit function of the left atrium – by 21.0 % and 16.9 %, accordingly. According to the ABPM results, the relationships between mean systolic, maximum systolic blood pressure, degree and duration of its day and active period increase and longitudinal myocardial deformation, conduit and reservoir function of the left atrium were established. Inhibition of the left atrium contractile function was associated with variability in systolic (r=–0.44, Р<0.01) and diastolic (r=–0.37, Р<0.01) blood pressure during passive period of the day. Conclusions. The relationship between performance indicators of ABPM and structural and functional state of the left heart was established. An adverse effect of insufficient night reduction of SBP on LV deformation and left atrium performance was shown.

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