We aimed to evaluate right ventricular (RV) deformation in recently diagnosed untreated hypertensive patients with different 24-h blood pressure (BP) patterns (dipping, nondipping, extreme dipping and reverse dipping). This cross-sectional study involved 190 untreated hypertensive patients who underwent 24-h ambulatory BP monitoring and a detailed two-dimensional echocardiographic examination, including the assessment of layer-specific strain. We found that 24-h and daytime BP values did not differ between the four groups. Nighttime BP significantly and gradually increased from extreme dippers across dippers and nondippers to reverse dippers. RV structure and systolic and diastolic function did not significantly differ among the four groups. However, RV global and RV free wall longitudinal strains were significantly lower in nondippers and reverse dippers than in dippers and extreme dippers. The endocardial and epicardial RV longitudinal strains of the whole RV and free wall RV were the lowest in reverse dippers and highest in extreme dippers. Multivariate logistic regression analysis demonstrated that only reverse dipping patterns were associated with reduced RV global longitudinal strain [OR 2.9 (95% CI: 1.5–8.2)], independent of age, sex, 24-h systolic BP, LV mass index, RV wall thickness and E/e’ t . Similarly, the reverse dipping pattern was associated with reduced RV free wall longitudinal strain, independently of the mentioned parameters [OR 3.8 (95% CI: 1.8–8.5)]. In conclusion, in the hypertensive population, the reverse dipping BP pattern had an adverse effect on RV deformation. RV remodeling progressively deteriorated from extreme dippers to reverse dippers, but only the reverse dipping BP pattern was independently associated with the reduction in RV longitudinal strain.

中文翻译：

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反倾角是否具有最高的右心室重构风险？

我们旨在评估具有不同 24 小时血压 (BP) 模式（浸渍、非浸渍、极度浸渍和反向浸渍）的最近诊断出的未经治疗的高血压患者的右心室 (RV) 变形。这项横断面研究涉及 190 名未经治疗的高血压患者，他们接受了 24 小时动态血压监测和详细的二维超声心动图检查，包括对特定层应变的评估。我们发现四组之间的 24 小时和白天血压值没有差异。夜间 BP 显着并逐渐增加，从极端北斗星跨越北斗星和非北斗星到反向北斗。RV 结构和收缩和舒张功能在四组之间没有显着差异。然而，非杓型和反向杓型的 RV 整体和 RV 游离壁纵向应变显着低于杓型和极端杓型。整个 RV 和游离壁 RV 的心内膜和心外膜 RV 纵向应变在逆杓型中最低，在极端杓型中最高。多变量逻辑回归分析表明，只有反向倾斜模式与 RV 整体纵向应变降低相关 [OR 2.9 (95% CI: 1.5–8.2)]，与年龄、性别、24 小时收缩压、LV 质量指数、RV 壁无关厚度和 E/e' t 。同样，反向倾斜模式与 RV 游离壁纵向应变降低有关，与上述参数无关 [OR 3.8 (95% CI: 1.8–8.5)]。总之，在高血压人群中，反向倾斜的 BP 模式对 RV 变形有不利影响。