Süleyman Cagan Efe MD, Mahmut Buğrahan Cicek MD, Tuba Unkun MD, Enver Yucel MD, Ali Karagöz MD, Cem Doğan MD, Zübeyde Bayram MD, Ali Furkan Tekatlı MD, Baver Bozan MD, Murat Karaçam MD, Gülümser Sevgin Halil MD, Turgut Karabağ MD, Cihangir Kaymaz MD, Nihal Ozdemir MD
{"title":"在跑步机运动测试中，心肌功参数可用于显示高血压反应异常的正常血压患者的亚临床心肌受累情况","authors":"Süleyman Cagan Efe MD, Mahmut Buğrahan Cicek MD, Tuba Unkun MD, Enver Yucel MD, Ali Karagöz MD, Cem Doğan MD, Zübeyde Bayram MD, Ali Furkan Tekatlı MD, Baver Bozan MD, Murat Karaçam MD, Gülümser Sevgin Halil MD, Turgut Karabağ MD, Cihangir Kaymaz MD, Nihal Ozdemir MD","doi":"10.1111/jch.14814","DOIUrl":null,"url":null,"abstract":"<p>Early determination of changes in myocardial functions is essential for the protection of cardiovascular diseases. This study aimed to evaluate myocardial work parameters in healthy individuals who developed an exaggerated hypertensive response during the treadmill exercise test procedure. The study included a total of 64 patients for whom an exercise electrocardiography test was planned for functional capacity evaluation. The study population was divided according to the presence of exaggerated hypertensive response to exercise (EBPRE) (SBP/DBP ≥210/105 mmHg in males ≥190/105 mmHg in females) and normal blood pressure response to exercise (NBPRE). Patients’ echocardiographic evaluations were made at rest, and myocardial work parameters were calculated. There was no statistical difference between the groups (NBPRE vs. EBPRE, respectively) in terms of left ventricular 2,3 and 4 chamber strains and global longitudinal strain (GLS) values (−20.6 ± −2.3, −19.7 ± −1.9, <i>p</i>:.13; −21.3 ± −2.7, −21 ± −2.4, <i>p</i>:.68; −21.2 ± −2.2, −21.2 ± −2.3, <i>p</i>:.93; and −20.8 ± −1.5, −20.4 ± −1.5, <i>p</i>:.23, respectively). Global constrictive work (GCW), global waste work (GWW), and global work efficiency (GWE) were not statistically different between the two groups (2374 ± 210, 2465 ± 204, <i>p</i>:.10; 142 ± 64, 127 ± 42, <i>p</i>:.31; 94.3 ± 2.5, 95.1 ± 1.5, <i>p</i>:.18, respectively). In contrast, global work index (GWI) parameters were different between the two groups (2036 ± 149, 2147 ± 150, <i>p</i> < .001). The GWI was independently associated with EBPRE (odds ratio with 95% 3.32 (1.02-11.24), <i>p</i> = .03). The partial effect plots were used for GWI to predict EBPRE, according to the results, an increase in GWI predicts probability of exaggerated hypertensive response. In conclusion, Myocardial work analyses might be used to identify early signs of myocardial involvement in normotensive patients with EBPRE.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14814","citationCount":"0","resultStr":"{\"title\":\"Usability of myocardial work parameters to demonstrate subclinical myocardial involvement in normotensive individuals with exaggerated hypertensive response in treadmill exercise testing\",\"authors\":\"Süleyman Cagan Efe MD, Mahmut Buğrahan Cicek MD, Tuba Unkun MD, Enver Yucel MD, Ali Karagöz MD, Cem Doğan MD, Zübeyde Bayram MD, Ali Furkan Tekatlı MD, Baver Bozan MD, Murat Karaçam MD, Gülümser Sevgin Halil MD, Turgut Karabağ MD, Cihangir Kaymaz MD, Nihal Ozdemir MD\",\"doi\":\"10.1111/jch.14814\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Early determination of changes in myocardial functions is essential for the protection of cardiovascular diseases. This study aimed to evaluate myocardial work parameters in healthy individuals who developed an exaggerated hypertensive response during the treadmill exercise test procedure. The study included a total of 64 patients for whom an exercise electrocardiography test was planned for functional capacity evaluation. The study population was divided according to the presence of exaggerated hypertensive response to exercise (EBPRE) (SBP/DBP ≥210/105 mmHg in males ≥190/105 mmHg in females) and normal blood pressure response to exercise (NBPRE). Patients’ echocardiographic evaluations were made at rest, and myocardial work parameters were calculated. There was no statistical difference between the groups (NBPRE vs. EBPRE, respectively) in terms of left ventricular 2,3 and 4 chamber strains and global longitudinal strain (GLS) values (−20.6 ± −2.3, −19.7 ± −1.9, <i>p</i>:.13; −21.3 ± −2.7, −21 ± −2.4, <i>p</i>:.68; −21.2 ± −2.2, −21.2 ± −2.3, <i>p</i>:.93; and −20.8 ± −1.5, −20.4 ± −1.5, <i>p</i>:.23, respectively). Global constrictive work (GCW), global waste work (GWW), and global work efficiency (GWE) were not statistically different between the two groups (2374 ± 210, 2465 ± 204, <i>p</i>:.10; 142 ± 64, 127 ± 42, <i>p</i>:.31; 94.3 ± 2.5, 95.1 ± 1.5, <i>p</i>:.18, respectively). In contrast, global work index (GWI) parameters were different between the two groups (2036 ± 149, 2147 ± 150, <i>p</i> < .001). The GWI was independently associated with EBPRE (odds ratio with 95% 3.32 (1.02-11.24), <i>p</i> = .03). The partial effect plots were used for GWI to predict EBPRE, according to the results, an increase in GWI predicts probability of exaggerated hypertensive response. In conclusion, Myocardial work analyses might be used to identify early signs of myocardial involvement in normotensive patients with EBPRE.</p>\",\"PeriodicalId\":50237,\"journal\":{\"name\":\"Journal of Clinical Hypertension\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14814\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Hypertension\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jch.14814\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Hypertension","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jch.14814","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Usability of myocardial work parameters to demonstrate subclinical myocardial involvement in normotensive individuals with exaggerated hypertensive response in treadmill exercise testing
Early determination of changes in myocardial functions is essential for the protection of cardiovascular diseases. This study aimed to evaluate myocardial work parameters in healthy individuals who developed an exaggerated hypertensive response during the treadmill exercise test procedure. The study included a total of 64 patients for whom an exercise electrocardiography test was planned for functional capacity evaluation. The study population was divided according to the presence of exaggerated hypertensive response to exercise (EBPRE) (SBP/DBP ≥210/105 mmHg in males ≥190/105 mmHg in females) and normal blood pressure response to exercise (NBPRE). Patients’ echocardiographic evaluations were made at rest, and myocardial work parameters were calculated. There was no statistical difference between the groups (NBPRE vs. EBPRE, respectively) in terms of left ventricular 2,3 and 4 chamber strains and global longitudinal strain (GLS) values (−20.6 ± −2.3, −19.7 ± −1.9, p:.13; −21.3 ± −2.7, −21 ± −2.4, p:.68; −21.2 ± −2.2, −21.2 ± −2.3, p:.93; and −20.8 ± −1.5, −20.4 ± −1.5, p:.23, respectively). Global constrictive work (GCW), global waste work (GWW), and global work efficiency (GWE) were not statistically different between the two groups (2374 ± 210, 2465 ± 204, p:.10; 142 ± 64, 127 ± 42, p:.31; 94.3 ± 2.5, 95.1 ± 1.5, p:.18, respectively). In contrast, global work index (GWI) parameters were different between the two groups (2036 ± 149, 2147 ± 150, p < .001). The GWI was independently associated with EBPRE (odds ratio with 95% 3.32 (1.02-11.24), p = .03). The partial effect plots were used for GWI to predict EBPRE, according to the results, an increase in GWI predicts probability of exaggerated hypertensive response. In conclusion, Myocardial work analyses might be used to identify early signs of myocardial involvement in normotensive patients with EBPRE.
期刊介绍：
The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.
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