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[Relationship between ambulatory blood pressure and myocardial performance index in hypertensive patients]
Shaomin Chen1, Baoxia Chen2, Ying Nie
1Department of Cardiology, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology & Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China.
Insights
Elevated blood pressure and blood pressure load in hypertensive patients are linked to a higher myocardial performance index (MPI). This suggests increased cardiac workload in individuals with uncontrolled hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Hypertension significantly impacts cardiovascular health.
- The myocardial performance index (MPI) reflects overall left ventricular function.
- Understanding the relationship between blood pressure and MPI is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate the association between ambulatory blood pressure parameters and myocardial performance index (MPI) in patients with untreated hypertension.
- To identify determinants of MPI in this patient cohort.
Main Methods:
- 76 untreated hypertensive patients underwent office blood pressure, 24-hour ambulatory blood pressure monitoring, and echocardiography.
- MPI was calculated using standard echocardiographic measurements.
- Patients were grouped based on MPI values (MPI>0.47 vs. MPI≤0.47) for comparison.
Main Results:
- Patients with higher MPI exhibited significantly higher 24-hour and daytime systolic and diastolic blood pressures, and blood pressure loads.
- Higher morning systolic blood pressure surges were also observed in the MPI>0.47 group.
- Nocturnal diastolic blood pressure and daytime systolic blood pressure load were independent predictors of MPI, along with LVMI and Em.
Conclusions:
- Increased blood pressure levels and blood pressure load are associated with elevated left ventricular MPI in hypertensive patients.
- Ambulatory blood pressure monitoring reveals significant associations with myocardial performance, highlighting potential subclinical cardiac dysfunction in hypertension.
Objective:
To explore the relationship between ambulatory blood pressure and myocardial performance index (MPI) in hypertensive patients.
Methods:
A total of 76 hospitalized patients with untreated hypertension from January to June 2013 were recruited. They received the examinations of office blood pressure, 24 h ambulatory blood pressure and echocardiography. MPI was determined by the following formula: MPI=(isovolumic contraction time+isovolumic relaxation time)/ejection time. Based upon left ventricular MPI, they were divided into two groups of MPI>0.47 (n=38) and MPI≤0.47 (n=38). The mean levels of office blood pressure, ambulatory blood pressure, blood pressure load, morning blood pressure surge (early morning blood pressure minus the lowest night-time blood pressure) and nocturnal blood pressure changes were compared between two groups. And the determinants of MPI were identified by multivariate regression analysis.
Results:
As compared to those with MPI≤0.47, patients with MPI>0.47 had higher 24 h and daytime systolic blood pressures, 24 h, daytime and nighttime diastolic blood pressures, 24 h, daytime and nighttime systolic blood pressure loads, 24 h, daytime and nighttime diastolic blood pressure loads and morning systolic blood pressure surges (all P<0.05). No inter-group differences existed in the mean levels of office blood pressure, nighttime systolic blood pressure, morning diastolic blood pressure surge, nocturnal systolic or diastolic blood pressure changes (all P>0.05). Multivariate regression analysis showed that nocturnal diastolic blood pressure (β=0.285, P=0.005) and daytime systolic blood pressure load (β=0.397, P<0.001) were independently associated with MPI. And other factors independently associated with MPI were left ventricular mass index (LVMI) and early diastolic mitral annular velocity (Em).
Conclusion:
The increases of blood pressure level and blood pressure load are associated with an elevation of left ventricular MPI.
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