24-Hour Profile of Arterial Blood Pressure in Patients with Acute Myocardial Infarction with Left Ventricular Dysfunction
Aim. To study 24-hour blood pressure profile in patients with acute myocardial infarction and to correlate its characteristics with parameters of systolic left ventricular function. Material and methods. 40 patients with acute myocardial infarction with left ventricular ejection fraction below 40% and symptoms of left ventricular failure (Killip class 1-2). Blood pressure monitoring and echocardiography for assessment of the left ventricular function were carried out on days 3-4 of infarction while patients were on standard therapy. Patients receiving angiotensin converting enzyme inhibitors or nitroglycerine infusion were not included. Results. 24-hour blood pressure profile on days 3-4 of myocardial infarction in 82% of patients receiving standard drug therapy was monophasic (24-hour index <10%, «non-dipper» category). Remaining 18% of patients belonged to «dipper» (10%) and «night-peaker» (8%) groups. Average values of 24-hour indexes for systolic and diastolic blood pressures were 5,88±1,44 and 7,71±1,69%, respectively, reflecting insufficient nocturnal blood pressure decline. 24 hour and nighttime variability of systolic blood pressure, daytime and nighttime variability of diastolic blood pressure directly closely correlated with end diastolic volume (r=0,524; 0,533; 0,536; 0,510, p=0,007; p=0,005; p=0,005; p=0,009, respectively).