ABSTRACT

Background: Arterial hypertension (AH) leads to systolic and/or diastolic dysfunction of the left ventricle (LV) by causing structural changes in the myocardium. Myocardial performance index (MPI) provides the evaluation of LV systolic and diastolic functions together. Prognostic nutritional index (PNI) is an indicator of immunonutritional status. PNI was studied in patients with malignancy, malnutrition, and cardiovascular diseases so far. It was aimed to investigate the relationship between PNI and MPI in hypertensive patients.

Methods: A total of 91 consecutive patients with newly diagnosed AH were included in the study. PNI was calculated according to the following formula: ((10 × serum albumin (g/dL))+(0.005 × total lymphocyte count)). MPI was obtained by dividing the sum of isovolumetric relaxation time (IVRT) and isovolumetric contraction time (IVCT) by the ejection time (ET) ((IVRT+IVCT)/ET). Patients were divided into two groups according to MPI is above or below the value of 0.5. The demographic characteristics and PNI values of patients were compared between two groups.

Results: There were 65 patients in the higher and 26 patients were in the normal MPI group. Higher MPI group had male predominance (p = .002). Diastolic blood pressure (p = .021), interventricular septum thickness (p = .005), posterior wall thickness (PWT) (p = .001), serum albumin concentration (p = .045), and PNI (p = .013) were differed between groups. Multivariate logistic regression analysis revealed that PWT [OR = 1.835, 95% CI: 1.126–2.992, p = .015] and PNI [OR = 1.161, 95% CI: 1.004–1.343, p = .018] predicted higher MPI.

Conclusion: Higher PNI was an independent predictor of LV dysfunction in newly diagnosed hypertensive patients. Immunonutritional status may be used as an indicator of the left ventricular function in patients with AH.

摘要

背景：动脉高压（AH）通过引起心肌结构改变而导致左心室（LV）的收缩和/或舒张功能障碍。心肌功能指数（MPI）可以一起评估LV的收缩和舒张功能。预后营养指数（PNI）是免疫营养状况的指标。迄今为止，已对恶性，营养不良和心血管疾病患者进行了PNI研究。目的是研究高血压患者的PNI和MPI之间的关系。

方法：本研究共纳入了91例新近诊断为AH的连续患者。根据以下公式计算PNI：（（10×血清白蛋白（g / dL））+（0.005×总淋巴细胞计数））。通过将等容松弛时间（IVRT）和等容收缩时间（IVCT）的总和除以喷射时间（ET）（（IVRT + IVCT）/ ET），可以得到MPI。根据MPI高于或低于0.5的值将患者分为两组。比较两组患者的人口统计学特征和PNI值。

结果：正常MPI组中高位65例，高位26例。MPI较高的组以男性占优势（p = .002）。舒张压（p = .021），室间隔厚度（p = .005），后壁厚度（PWT）（p = .001），血清白蛋白浓度（p = .045）和PNI（p = .013 ）在各组之间有所不同。多元逻辑回归分析显示，PWT [OR = 1.835，95％CI：1.126-2.992，p = .015]和PNI [OR = 1.161，95％CI：1.004-1.343，p = .018 ]预测较高的MPI。

结论：较高的PNI是新诊断的高血压患者左室功能障碍的独立预测因子。免疫营养状况可以作为AH患者左心室功能的指标。