Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude
Abstract Acute high‐altitude (HA) exposure induces physiological responses of the heart and blood pressure (BP). However, few studies have investigated the responses associated with dipper and non‐dipper BP patterns. In this prospective study, 72 patients underwent echocardiography and 24‐h ambulato...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-06-01
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| Series: | The Journal of Clinical Hypertension |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jch.14235 |
| _version_ | 1797645249781170176 |
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| author | Renzheng Chen Jie Yang Chuan Liu Jingbin Ke Xubin Gao Yuanqi Yang Yang Shen Fangzhengyuan Yuan Chunyan He Ran Cheng Hailin Lv Chen Zhang Wenzhu Gu Hu Tan Jihang Zhang Lan Huang |
| author_facet | Renzheng Chen Jie Yang Chuan Liu Jingbin Ke Xubin Gao Yuanqi Yang Yang Shen Fangzhengyuan Yuan Chunyan He Ran Cheng Hailin Lv Chen Zhang Wenzhu Gu Hu Tan Jihang Zhang Lan Huang |
| author_sort | Renzheng Chen |
| collection | DOAJ |
| description | Abstract Acute high‐altitude (HA) exposure induces physiological responses of the heart and blood pressure (BP). However, few studies have investigated the responses associated with dipper and non‐dipper BP patterns. In this prospective study, 72 patients underwent echocardiography and 24‐h ambulatory BP testing at sea level and HA. Patients were divided into dipper and non‐dipper groups according to BP at sea level. Acute HA exposure elevated 24‐h systolic and diastolic BP and increased BP variability, particularly in the morning. Moreover, acute exposure increased left ventricular torsion, end‐systolic elastance, effective arterial elastance, and untwisting rate, but reduced peak early diastolic velocity/late diastolic velocity and peak early diastolic velocity/early diastolic velocity, implying enhanced left ventricular systolic function but impaired filling. Dippers showed pronounced increases in night‐time BP, while non‐dippers showed significant elevation in day‐time BP, which blunted differences in nocturnal BP fall, and lowest night‐time and evening BP. Dippers had higher global longitudinal strain, torsion, and untwisting rates after acute HA exposure. Variations in night‐time systolic BP correlated with variations in torsion and global longitudinal strain. Our study firstly demonstrates BP and cardiac function variations during acute HA exposure in different BP patterns and BP increases in dippers at night, while non‐dippers showed day‐time increases. Furthermore, enhanced left ventricular torsion and global longitudinal strain are associated with BP changes. Non‐dippers showed poor cardiac compensatory and maladaptive to acute HA exposure. However, the exact mechanisms involved need further illumination. |
| first_indexed | 2024-03-11T14:43:38Z |
| format | Article |
| id | doaj.art-aaf09ed170a147189d90090983bfe20d |
| institution | Directory Open Access Journal |
| issn | 1524-6175 1751-7176 |
| language | English |
| last_indexed | 2024-03-11T14:43:38Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj.art-aaf09ed170a147189d90090983bfe20d2023-10-30T13:26:08ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762021-06-012361133114310.1111/jch.14235Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitudeRenzheng Chen0Jie Yang1Chuan Liu2Jingbin Ke3Xubin Gao4Yuanqi Yang5Yang Shen6Fangzhengyuan Yuan7Chunyan He8Ran Cheng9Hailin Lv10Chen Zhang11Wenzhu Gu12Hu Tan13Jihang Zhang14Lan Huang15Institute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaInstitute of Cardiovascular Diseases of PLA the Second Affiliated Hospital Third Military Medical University (Army Medical University) Chongqing ChinaAbstract Acute high‐altitude (HA) exposure induces physiological responses of the heart and blood pressure (BP). However, few studies have investigated the responses associated with dipper and non‐dipper BP patterns. In this prospective study, 72 patients underwent echocardiography and 24‐h ambulatory BP testing at sea level and HA. Patients were divided into dipper and non‐dipper groups according to BP at sea level. Acute HA exposure elevated 24‐h systolic and diastolic BP and increased BP variability, particularly in the morning. Moreover, acute exposure increased left ventricular torsion, end‐systolic elastance, effective arterial elastance, and untwisting rate, but reduced peak early diastolic velocity/late diastolic velocity and peak early diastolic velocity/early diastolic velocity, implying enhanced left ventricular systolic function but impaired filling. Dippers showed pronounced increases in night‐time BP, while non‐dippers showed significant elevation in day‐time BP, which blunted differences in nocturnal BP fall, and lowest night‐time and evening BP. Dippers had higher global longitudinal strain, torsion, and untwisting rates after acute HA exposure. Variations in night‐time systolic BP correlated with variations in torsion and global longitudinal strain. Our study firstly demonstrates BP and cardiac function variations during acute HA exposure in different BP patterns and BP increases in dippers at night, while non‐dippers showed day‐time increases. Furthermore, enhanced left ventricular torsion and global longitudinal strain are associated with BP changes. Non‐dippers showed poor cardiac compensatory and maladaptive to acute HA exposure. However, the exact mechanisms involved need further illumination.https://doi.org/10.1111/jch.14235ambulatory blood pressurecardiac functioncardiac mechanicsdipping patternhigh altitude |
| spellingShingle | Renzheng Chen Jie Yang Chuan Liu Jingbin Ke Xubin Gao Yuanqi Yang Yang Shen Fangzhengyuan Yuan Chunyan He Ran Cheng Hailin Lv Chen Zhang Wenzhu Gu Hu Tan Jihang Zhang Lan Huang Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude The Journal of Clinical Hypertension ambulatory blood pressure cardiac function cardiac mechanics dipping pattern high altitude |
| title | Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude |
| title_full | Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude |
| title_fullStr | Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude |
| title_full_unstemmed | Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude |
| title_short | Blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude |
| title_sort | blood pressure and left ventricular function changes in different ambulatory blood pressure patterns at high altitude |
| topic | ambulatory blood pressure cardiac function cardiac mechanics dipping pattern high altitude |
| url | https://doi.org/10.1111/jch.14235 |
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