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Does Masked Hypertension Cause Early Left Ventricular Impairment in Youth?

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机构: [1]Department of Ultrasonography, Shenzhen Hospital, Southern Medical University, Shenzhen, China, [2]Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China, [3]Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, [4]Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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关键词: masked hypertension youth two-dimensional echocardiography layer-specific speckle tracking analysis left ventricular function

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Objectives: Masked hypertension (MH) is not uncommon in the youth and may increase risks of long-term cardiovascular impairment. However, little is known about the subclinical heart damage in this group of patients. Currently, 3-layer speckle tracking imaging based on two-dimensional echocardiography is feasible to detect the early signs of myocardial damage. We therefore aimed to investigate whether subtle changes of cardiac function occurred in the young MH patients by using advanced quantification with layer-specific speckle tracking. Methods: A total of 40 adolescents with MH (age 18 +/- 3 years, 73% males) and 40 age-, gender-, race-, and height-matched normotensive volunteers were enrolled in our study. MH was defined as one or more of the ambulatory blood pressure (BP) parameters (24-h, daytime and night-time average BPs) higher than >= 95th percentile for gender and height according to the local reference. Both comprehensive two-dimensional echocardiography with layer-specific strain analysis and 24-h ambulatory BP monitoring were performed. Longitudinal strain and circumferential strain in endocardial, mid-myocardial, and epicardial layers were determined accordingly with the dedicated software (EchoPAC software version 201, GE Healthcare, Horten, Norway). Results: Compared with normotensive controls, youths with MH had higher ambulatory pulse rate and left ventricular mass index, and were more obese. Interestingly, similar ventricular volumes and ejection fraction were observed in the study groups, but further analysis with layer-specific strains revealed that endocardial and mid-myocardial longitudinal and circumferential mechanical function were decreased in the young MH subjects when compared to normotensive individuals (all p < 0.05). However, there were no difference regarding radial strain and apical rotation derived from traditional speckle tracking analysis. Conclusion: Subclinical change of LV mechanic function assessed by layer-specific speckle tracking is present in youth with MH despite considered as normal with conventional ways.Thus, MH in youth should be monitored closely instead of labeling as an entirely benign entity.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 儿科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 儿科
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出版当年[2016]版:
Q2 PEDIATRICS
最新[2023]版:
Q2 PEDIATRICS

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Ultrasonography, Shenzhen Hospital, Southern Medical University, Shenzhen, China,
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通讯机构: [2]Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China, [3]Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China, [4]Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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