Evaluating Impact of Pulse Pressure on Indexes of Myocardial Work by Speckle-Tracking Echocardiography in Normotensive, Prehypertensive and Newly Diagnosed Hypertensive Patients

Abstract

Zheng Qin,1 Dawei Liu,2 Xiaojun You,3 Qin Duan,3 Yu Zhao1 1Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China; 2Department of Cardiovascular Medicine, The Bishan Hospital of Chongqing Medical University, Chongqing, 402760, People’s Republic of China; 3Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of ChinaCorrespondence: Qin Duan, Department of Cardiovascular Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email [email protected] Yu Zhao, Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China, Email [email protected]: The impact of pulse pressure (PP) on indexes of myocardial work (MWIs). This study aims to explore the potential association of high PP with myocardial work (MW).Hypothesis: PP had an association with four indexes of MW in a mixed population of normotensive, prehypertensive and newly diagnosed hypertensive individuals.Methods: The study was a single-center, cross-sectional, observational study. A total of 204 participants (66 normotensive, 35 prehypertensive and 103 newly diagnosed hypertensive individuals) were evaluated by speckle-tracking echocardiography (STE) and blood pressure measurement. According to the PP tertiles, the participants were divided into three groups: Group I (< 44 mmHg, n=67), Group II (44– 52 mmHg, n=68) and Group III (≥ 52 mmHg, n=69).Results: In Group II and Group III, the proportion of males was higher than that in Group I (median 46 vs 30 (P=0.002)). With increasing PP, the three indexes of MW, namely, GWI, GCW and GWW, increased, and the differences among the three groups were statistically significant (P< 0.001). PP was positively related to GWI, GCW and GWW and negatively correlated with GWE. After adjusting for E/e’, LVMI, LAVI and GLS, PP was still significantly correlated with the four MW indexes (both P< 0.001).Conclusion: PP had a strong association with four indexes of MW in a mixed population of normotensive, prehypertensive and newly diagnosed hypertensive individuals. The evaluation of PP and MWIs might be valuable for identifying very early diastolic impairment of the heart.Keywords: arterial stiffness, myocardial work, hypertension, speckle-tracking echocardiography, pulse pressure

Keywords

• arterial stiffness
• myocardial work
• hypertension
• speckle-tracking echocardiography
• pulse pressure