This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Di Bello, V. Articles by Giusti, C. Search for Related Content PubMed PubMed Citation Articles by Di Bello, V. Articles by Giusti, C. Social Bookmarking                         What's this?

Microalbuminuria, Pulse Pressure, Left Ventricular Hypertrophy, and Myocardial Ultrasonic Tissue Characterization In Essential Hypertension

Roberto Pedrinelli

Davide Giorgi

Alessio Bertini

Maria Teresa Caputo

Adriano Cioppi

Enrica Talini

Moretti Leonardo

Giulia Dell'Omo

Marco Paterni

Costantino Giusti

Microalbuminuria (UAE) may be considered a marker of systemic vascular dysfunction, while pulse pressure (PP) is an indicator of the stiffness of vascular conduits. Both these parame ters, together with left ventricular hypertrophy (LVH), are linked to cardiovascular morbidity in hypertensive patients. The aim of this study was the analysis of the possible relationships among UAE, PP, and LVH with ultrasonic myocardial textural parameters, which are altered in hypertensives patients. A group of male (n = 70) essential hypertensive patients (mean age: 58 ±7 yr) was analyzed with a group of age-comparable normotensive healthy subjects as controls (n = 32). Ambulatory blood pressure monitoring (ABPM) was performed with an oscil lometric monitor; UAE was measured by nephelometry. A conventional 2D-Doppler echocar diography (to analyze left ventricular mass: LVM) and a quantitative analysis of the echocar diographic digitized imaging with the use of a calibrated digitization system (to calculate the septum and the posterior wall textural parameters) were performed on all subjects. The myocardial mean gray level was calculated to derive the cyclic variation index (CVI).

The CVI was significantly lower in hypertensives both for the septum (-16.3 ±22.8 vs 34.7 ±15.3%; p < 0.001 ) and for the posterior wall (-15.2 ±23.6 vs 38.2 ±15.4%; p < 0.001 ). A signifi cant negative correlation was found between logUAE and the CVI of the septum (r = -0.42; p<0.001), between the PP and the CVI of the septum (r = -0.40; p<0.002) and between the CVI and the LVM (r = -0.38; p<0.001). Multiple regression analysis having as dependent variable the CVI at septum level showed as significantly related independent variables: PP (p<0.01), logUAE (p < 0.001), and LVM (p<0.05) (multiple R: 0.76, squared multiple R: 0.57; p<0.001 ).

It was found that LVM, logUAE, and PP are all correlated with textural parameters, and the CVI can be considered a sensitive parameter in the identification of an abnormal myocardial texture in hypertension. A high level of arterial stiffness and the presence of vascular dysfunc tion in essential hypertension could participate in the determination of myocardial alterations and permit the identification of patients with the worst prognosis in terms of morbidity or mortality due to cardiovascular events.

Angiology, Vol. 52, No. 3, 175-183 (2001)
DOI: 10.1177/000331970105200303


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?