Browsing by Author "Ivanovic, Branislava A. (24169010000)"

Objective The purpose of this study was to determine the influence of a nondipping arterial blood pressure pattern on the right ventricular (RV) structure, diastolic, and global function in recently diagnosed hypertensive patients. Methods This cross-sectional study included 189 recently diagnosed hypertensive patients. All participants underwent 24 h ambulatory blood pressure monitoring and a complete two-dimensional echocardiography examination. We determined the ratio of early diastolic transtricuspid and septal areas of the tricuspid annulus flow velocities (E/e')t, as well as appropriate time intervals for the estimation of the Tei index. RV hypertrophy was defined by RV wall thickness of at least 6.0mm in men and at least 5.5mm in women. Results The dipping blood pressure pattern was found in 107 (57%) participants, whereas the nondipping pattern was present in 82 (43%) hypertensive patients. The RV wall thickness as well as the (E/e')t ratio (5.12 ±1.03 vs. 5.81± 1.12, P < 0.001) and the RV Tei index (0.42 ±0.08 vs. 0.48 ±0.11, P < 0.001) were increased in the nondippers (4.2 ± 0.84 vs. 4.7± 0.87mm, P <0.001). Analyses revealed that 24 h, daytime, and night-time systolic blood pressure, the nondipping status, and the left ventricular mass index were independently associated with RV wall thickness (P < 0.001 for all). The same parameters, along with RV wall thickness, were identified as independent predictors of RV diastolic function [(E/e') t] and RV global function (RV Tei index), respectively. Conclusion RV structure, diastolic, and global functions were significantly impaired in nondipper hypertensive patients. A nondipping blood pressure pattern represents one of the independent predictors of RV diastolic and global function as well as RV hypertrophy. © 2012 Wolters Kluwer Health.

Objective The purpose of this study was to determine the influence of a nondipping arterial blood pressure pattern on the right ventricular (RV) structure, diastolic, and global function in recently diagnosed hypertensive patients. Methods This cross-sectional study included 189 recently diagnosed hypertensive patients. All participants underwent 24 h ambulatory blood pressure monitoring and a complete two-dimensional echocardiography examination. We determined the ratio of early diastolic transtricuspid and septal areas of the tricuspid annulus flow velocities (E/e')t, as well as appropriate time intervals for the estimation of the Tei index. RV hypertrophy was defined by RV wall thickness of at least 6.0mm in men and at least 5.5mm in women. Results The dipping blood pressure pattern was found in 107 (57%) participants, whereas the nondipping pattern was present in 82 (43%) hypertensive patients. The RV wall thickness as well as the (E/e')t ratio (5.12 ±1.03 vs. 5.81± 1.12, P < 0.001) and the RV Tei index (0.42 ±0.08 vs. 0.48 ±0.11, P < 0.001) were increased in the nondippers (4.2 ± 0.84 vs. 4.7± 0.87mm, P <0.001). Analyses revealed that 24 h, daytime, and night-time systolic blood pressure, the nondipping status, and the left ventricular mass index were independently associated with RV wall thickness (P < 0.001 for all). The same parameters, along with RV wall thickness, were identified as independent predictors of RV diastolic function [(E/e') t] and RV global function (RV Tei index), respectively. Conclusion RV structure, diastolic, and global functions were significantly impaired in nondipper hypertensive patients. A nondipping blood pressure pattern represents one of the independent predictors of RV diastolic and global function as well as RV hypertrophy. © 2012 Wolters Kluwer Health.

Purpose: The aim of this study was to investigate the influence of metabolic syndrome (MS) on left ventricular (LV) structure and function depending on gender. Methods: The study included 235 never-treated MS subjects and 138 controls. MS was defined as the presence of three or more National Cholesterol Education Program's Adult Treatment Panel III criteria. All the subjects underwent laboratory blood tests and complete two-dimensional, pulsed, and tissue Doppler echocardiography. Results: LV structure, diastolic function, and global function were significantly impaired in all MS subjects. Multivariate analysis of individual MS factors showed that increased blood pressure (BP) and impaired fasting glucose were independently associated with LV hypertrophy in women, whereas the only independent predictor in men was increased BP. The same analysis revealed that the combination of impaired glucose level, abdominal obesity, and dyslipidemia was associated with LV hypertrophy only in women. Higher BP, impaired fasting glucose, and triglycerides level were independently associated with LV diastolic dysfunction in women, whereas higher BP was the only independent predictor in men. The combination of increased BP, fasting glucose, and dyslipidemia was independently associated with LV diastolic dysfunction only in women. Conclusions: Different MS factors are responsible for LV remodeling in women and men. The metabolic sequence of MS is more important for LV remodeling in women. © 2013 Wiley Periodicals, Inc.

Background The aim of this study was to examine the impact of metabolic syndrome (MS) on right ventricular (RV) remodeling in different genders. Methods The study included 341 subjects (216 subjects with MS and 125 controls). MS was defined by the presence of ≥3 ATP-NCEP-III criteria. All subjects underwent complete two-dimensional echocardiography. Results RV structure, diastolic, and global function were significantly impaired in MS subjects, in both genders. The multiple regression analysis of MS parameters showed that systolic blood pressure (BP) and waist circumference were independently associated with RV wall thickness in women, whereas the only independent predictor in men was systolic BP. The multivariate logistic regression analysis revealed that increased BP, impaired fasting glucose, and dyslipidemia were a combination of MS risk factors related with RV hypertrophy solely in women. Increased systolic BP, impaired fasting glucose, and abdominal obesity were independently associated with tricuspid E/e′ in women, whereas increased systolic BP was the only independent predictor in men. Impaired fasting glucose, abdominal obesity, and dyslipidemia were a combination of MS criteria, which was independently associated with RV diastolic dysfunction only in women. Conclusions Different parameters of MS are responsible for RV remodeling in women and men. The metabolic parameters of MS are more important for RV remodeling in women. © 2013, Wiley Periodicals, Inc.

Background: The aim of our study was to determine clinical and echocardiographic parameters, which impacted the left (LV) and right ventricular (RV) diastolic and global function in patients with systemic sclerosis (SSc). Methods: The study included 50 SSc patients and 48 age-matched healthy volunteers. All the patients underwent clinical examination, serological tests, pulmonary function testing, and complete two-dimensional echocardiography, which included pulsed and tissue Doppler. We determined the ratio of early diastolic transtricuspid/transmitral and the lateral area of the tricuspid/mitral annulus flow velocities (E/e′; lateral). RV and LV global ventricular function was estimated by the Tei index. Pulmonary vascular resistance (PVR) was calculated by using echocardiographic parameters. Results: Tricuspid inflow E/A ratio was decreased in the SSc group (P < 0.001), also as e′/a′ ratio (P < 0.001), whereas E/e′ tricuspid was increased (P = 0.001). The RV Tei index was increased in SSc patients (P < 0.001). PVR was significantly higher than in controls (P < 0.001). The multivariate analysis showed that brain natriuretic peptide (BNP) level (β= 0.403, P = 0.016), diffusion capacity for carbon monoxide (DLCO; β= 0.361, P = 0.025), RV systolic pressure (β= 0.449, P = 0.011), and PVR (β= 0.507, P < 0.001) were independently associated with RV diastolic function (tricuspid E/e′ lateral). Similar results were achieved for the RV Tei index. Multiple regression showed that BNP level (β= 0.337, P = 0.029), DLCO (β= 0.405, P = 0.011), and PVR (β= 0.449, P = 0.022) were independently associated with LV diastolic function (mitral E/ e′ lateral). Similar results were obtained for the LV Tei index. Conclusion: Our study revealed some new noninvasive parameters (BNP, DLCO, and PVR), which are useful for everyday clinical practice for determining of early myocardial involvement in SSc. © 2011, Wiley Periodicals, Inc.