Left ventricular global function index and peculiarities of daily blood pressure profile in patients with arterial hypertension

BACKGROUND: The left ventricular global function index (LVGFI), determined using transthoracic echocardiography, is a simple clinical marker of left ventricular dysfunction and has superior prognostic value to the standard ejection fraction-based assessment of cardiac pump function. The methodology for calculating this index was proposed in 2019. Currently, the clinical factors that influence the state of left ventricular global functions are not examined.

AIM: This study aimed to assess the association of LVGFI with the peculiarities of daily blood pressure (BP) profile in patients with arterial hypertension (AH).

MATERIALS AND METHODS: A total of 104 patients [51 men (49%) and 53 (51%) women] with AH were examined. The mean age of the patients was 58.7±11.73 years, and disease duration was 6.03±10.93 years. AH corresponded to grades 1, 2, and 3 in 47 (45.2%), 26 (25.0%), and 31 (29.8%) patients, respectively. Patients with myocardial infarction or stroke, cardiomyopathies, heart defects, diabetes mellitus, thyroid dysfunction, or chronic kidney disease were not included in the study. All patients underwent daily BP monitoring, echocardiography, carotid artery examination, and biochemical blood tests.

RESULTS: A significant inverse weak correlation of LVGFI with age (r=−0.215, p=0.028), body mass index (r=−0.378, p=0.001), BP variability (r=−0.307, p=0.002), and daily mean values of systolic (r=−0.223, p=0.026) and diastolic (r=−0.237, p=0.018) BP were observed. In the regression analysis, an increase in body mass index, abnormal diurnal BP with excessive BP reduction at night, and high BP variability demonstrated a significant and independent association with decreased LVGFI.

CONCLUSIONS: The study revealed an independent association of decreased LVGFI with increased body mass index, excessive BP reduction at night, and high systolic BP variability. These factors should be considered in the possible development of a strategy to prevent target organ damage in AH.