The Impact of White-Coat Hypertension on Cardiac Mechanics

The authors aimed to investigate right ventricular (RV) and left ventricular (LV) remodeling in patients with white-coat hypertension (WCH) and sustained arterial hypertension. This cross-sectional study included 153 untreated patients who underwent 24-hour ambulatory blood pressure (BP) monitoring and complete two-dimensional echocardiographic (2DE) examination. Results showed that LV and RV longitudinal mechanics gradually deteriorated from controls to patients with sustained hypertension. Endocardial RV longitudinal strain was lower in WCH and hypertensive patients than in controls. Midmyocardial RV longitudinal strain was decreased in hypertensive patients compared with the other two groups, whereas subepicardial RV longitudinal strain was similar between the observed groups. Twenty-four–hour systolic BP was associated with 2DE global longitudinal LV and subendocardial RV strain. This study demonstrates that myocardial deformation of both ventricles is significantly impaired in patients with WCH and sustained arterial hypertension, and 24-hour systolic BP is associated with LV and RV deformation independent of cardiac structure.