Nocturnal hypertension and right heart remodeling

Background: We sought to investigate right ventricular (RV) and right atrial mechanics in patients with daytime, night-Time and daytime-night-Time hypertension. Methods: This cross-sectional study included 256 untreated patients who underwent 24-h ambulatory blood pressure monitoring and complete echocardiographic examination including strain analysis. Night-Time hypertension was defined as nocturnal SBP at least 120mmHg and/or DBP at least 70mmHg and daytime hypertension as SBP at least 135mmHg and/or DBP at least 85mmHg. Results: RV structure, diastolic function and global longitudinal RV strain in patients with nocturnal hypertension are intermediate between daytime and daytime-night-Time hypertension. On the other side, RV systolic and diastolic strain rates referring to the RV free wall are significantly deteriorated in the patients with nocturnal and daytime-night-Time hypertension in comparison with normotension and daytime hypertension. Right atrial conduit function is significantly reduced in the patients with nocturnal and day-night-Time hypertension comparing with other two groups, whereas right atrial reservoir and pump functions are intermediate between daytime and daytime-night-Time hypertension. A 24-h SBP is independently of other clinical and echocardiographic parameters associated with RV and right atrial global strain. Conclusion: RV mechanics is worse in night-Time and daytime-night-Time hypertensive patients than in normotensive controls and isolated daytime hypertensive patients. A 24-h SBP is independently associated with right heart mechanics.