Relationship of Office and Ambulatory Blood Pressure with Left Ventricular Global Longitudinal Strain

Fusako Sera, Zhezhen Jin, Cesare Russo, Edward S. Lee, Joseph E. Schwartz, Tatjana Rundek, Mitchell S V Elkind, Shunichi Homma, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND Left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LV ejection fraction (LVEF) is normal, and is an independent predictor of cardiovascular events. Ambulatory blood pressure (BP) is a better predictor of cardiovascular events, including heart failure, than office BP. We investigated the association of office and ambulatory BP measurements with subclinical LV systolic dysfunction in a community-based cohort with normal LVEF. METHODS Two-dimensional speckle-tracking echocardiography and 24-hour ambulatory BP monitoring were performed in 577 participants (mean age 70±9 years; 60% women) with LVEF ≥50% from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. Univariable and multivariable linear regression analyses were used to assess the associations of BP measures with GLS. RESULTS Higher ambulatory and office BP values were consistently associated with impaired GLS. After adjustment for pertinent covariates (age, sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, LV mass index, and antihypertensive medication), office diastolic BP and ambulatory systolic and diastolic BPs (24-hour, daytime and nighttime) were independently associated with GLS (P = 0.003 for office DBP, P ≤ 0.001 for all ambulatory BPs). When ambulatory and office BP values were included in the same model, all ambulatory BP measures remained significantly associated with GLS (all P < 0.01), whereas office BP values were not. CONCLUSIONS Ambulatory BP values are significantly associated with impaired GLS and the association is stronger than for office BP. Ambulatory BP monitoring might have a role in the risk stratification of hypertensive patients for early LV dysfunction.

Original languageEnglish (US)
Pages (from-to)1261-1267
Number of pages7
JournalAmerican Journal of Hypertension
Volume29
Issue number11
DOIs
StatePublished - Nov 1 2016

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Blood Pressure
Ambulatory Blood Pressure Monitoring
Left Ventricular Dysfunction
Cardiovascular Abnormalities
Stroke Volume
Antihypertensive Agents
Echocardiography
Coronary Artery Disease
Linear Models
Diabetes Mellitus
Body Mass Index
Heart Failure
Regression Analysis
Brain

Keywords

  • left ventricular function

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Relationship of Office and Ambulatory Blood Pressure with Left Ventricular Global Longitudinal Strain. / Sera, Fusako; Jin, Zhezhen; Russo, Cesare; Lee, Edward S.; Schwartz, Joseph E.; Rundek, Tatjana; Elkind, Mitchell S V; Homma, Shunichi; Sacco, Ralph L; Di Tullio, Marco R.

In: American Journal of Hypertension, Vol. 29, No. 11, 01.11.2016, p. 1261-1267.

Research output: Contribution to journalArticle

Sera, F, Jin, Z, Russo, C, Lee, ES, Schwartz, JE, Rundek, T, Elkind, MSV, Homma, S, Sacco, RL & Di Tullio, MR 2016, 'Relationship of Office and Ambulatory Blood Pressure with Left Ventricular Global Longitudinal Strain', American Journal of Hypertension, vol. 29, no. 11, pp. 1261-1267. https://doi.org/10.1093/ajh/hpv188
Sera, Fusako ; Jin, Zhezhen ; Russo, Cesare ; Lee, Edward S. ; Schwartz, Joseph E. ; Rundek, Tatjana ; Elkind, Mitchell S V ; Homma, Shunichi ; Sacco, Ralph L ; Di Tullio, Marco R. / Relationship of Office and Ambulatory Blood Pressure with Left Ventricular Global Longitudinal Strain. In: American Journal of Hypertension. 2016 ; Vol. 29, No. 11. pp. 1261-1267.
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abstract = "BACKGROUND Left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LV ejection fraction (LVEF) is normal, and is an independent predictor of cardiovascular events. Ambulatory blood pressure (BP) is a better predictor of cardiovascular events, including heart failure, than office BP. We investigated the association of office and ambulatory BP measurements with subclinical LV systolic dysfunction in a community-based cohort with normal LVEF. METHODS Two-dimensional speckle-tracking echocardiography and 24-hour ambulatory BP monitoring were performed in 577 participants (mean age 70±9 years; 60{\%} women) with LVEF ≥50{\%} from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. Univariable and multivariable linear regression analyses were used to assess the associations of BP measures with GLS. RESULTS Higher ambulatory and office BP values were consistently associated with impaired GLS. After adjustment for pertinent covariates (age, sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, LV mass index, and antihypertensive medication), office diastolic BP and ambulatory systolic and diastolic BPs (24-hour, daytime and nighttime) were independently associated with GLS (P = 0.003 for office DBP, P ≤ 0.001 for all ambulatory BPs). When ambulatory and office BP values were included in the same model, all ambulatory BP measures remained significantly associated with GLS (all P < 0.01), whereas office BP values were not. CONCLUSIONS Ambulatory BP values are significantly associated with impaired GLS and the association is stronger than for office BP. Ambulatory BP monitoring might have a role in the risk stratification of hypertensive patients for early LV dysfunction.",
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T1 - Relationship of Office and Ambulatory Blood Pressure with Left Ventricular Global Longitudinal Strain

AU - Sera, Fusako

AU - Jin, Zhezhen

AU - Russo, Cesare

AU - Lee, Edward S.

AU - Schwartz, Joseph E.

AU - Rundek, Tatjana

AU - Elkind, Mitchell S V

AU - Homma, Shunichi

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - BACKGROUND Left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LV ejection fraction (LVEF) is normal, and is an independent predictor of cardiovascular events. Ambulatory blood pressure (BP) is a better predictor of cardiovascular events, including heart failure, than office BP. We investigated the association of office and ambulatory BP measurements with subclinical LV systolic dysfunction in a community-based cohort with normal LVEF. METHODS Two-dimensional speckle-tracking echocardiography and 24-hour ambulatory BP monitoring were performed in 577 participants (mean age 70±9 years; 60% women) with LVEF ≥50% from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. Univariable and multivariable linear regression analyses were used to assess the associations of BP measures with GLS. RESULTS Higher ambulatory and office BP values were consistently associated with impaired GLS. After adjustment for pertinent covariates (age, sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, LV mass index, and antihypertensive medication), office diastolic BP and ambulatory systolic and diastolic BPs (24-hour, daytime and nighttime) were independently associated with GLS (P = 0.003 for office DBP, P ≤ 0.001 for all ambulatory BPs). When ambulatory and office BP values were included in the same model, all ambulatory BP measures remained significantly associated with GLS (all P < 0.01), whereas office BP values were not. CONCLUSIONS Ambulatory BP values are significantly associated with impaired GLS and the association is stronger than for office BP. Ambulatory BP monitoring might have a role in the risk stratification of hypertensive patients for early LV dysfunction.

AB - BACKGROUND Left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LV ejection fraction (LVEF) is normal, and is an independent predictor of cardiovascular events. Ambulatory blood pressure (BP) is a better predictor of cardiovascular events, including heart failure, than office BP. We investigated the association of office and ambulatory BP measurements with subclinical LV systolic dysfunction in a community-based cohort with normal LVEF. METHODS Two-dimensional speckle-tracking echocardiography and 24-hour ambulatory BP monitoring were performed in 577 participants (mean age 70±9 years; 60% women) with LVEF ≥50% from the Cardiovascular Abnormalities and Brain Lesions (CABL) study. Univariable and multivariable linear regression analyses were used to assess the associations of BP measures with GLS. RESULTS Higher ambulatory and office BP values were consistently associated with impaired GLS. After adjustment for pertinent covariates (age, sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, LV mass index, and antihypertensive medication), office diastolic BP and ambulatory systolic and diastolic BPs (24-hour, daytime and nighttime) were independently associated with GLS (P = 0.003 for office DBP, P ≤ 0.001 for all ambulatory BPs). When ambulatory and office BP values were included in the same model, all ambulatory BP measures remained significantly associated with GLS (all P < 0.01), whereas office BP values were not. CONCLUSIONS Ambulatory BP values are significantly associated with impaired GLS and the association is stronger than for office BP. Ambulatory BP monitoring might have a role in the risk stratification of hypertensive patients for early LV dysfunction.

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U2 - 10.1093/ajh/hpv188

DO - 10.1093/ajh/hpv188

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