The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients.

BACKGROUND

Hypertension is a risk factor for cardiovascular disease. The present study aimed to explore the impact of ambulatory blood pressure load (BPL) on mitral regurgitation (MR) in continuous ambulatory peritoneal dialysis (CAPD) patients.

METHODS

A total of 215 CAPD patients hospitalized in the Department of Nephrology at the Fifth Affiliated Hospital of Sun Yat-sen University between November 2017 and June 2022 were included in the study. All subjects underwent 24-h ambulatory BP monitoring and an echocardiography examination. BPL and MR area (MRA) were calculated. Subjects were divided into high regurgitation group and non-high regurgitation group. General data were also collected. The effect of ambulatory BPL on MR in CAPD patients was analyzed using multiple linear regression.

RESULTS

Baseline data comparison revealed statistically significant differences in hemoglobin, serum β2-microglobulin, NT-proBNP, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVDD), LV ejection fraction (LVEF), LV fractional shortening (LVFS), and mitral valve calcification between the high and non-high regurgitation groups (P < 0.05). There was no statistically significant difference in other clinical characteristics. Correlation analysis showed correlations between MRA and 24-h systolic BPL (24h-SBPL), 24-h diastolic BPL (24h-DBPL), daytime systolic BPL (D-SBPL), daytime DBPL (D-DBPL), nighttime systolic BPL (N-SBPL), nighttime DBPL (N-DBPL), hemoglobin level, NT-proBNP level, LAD, LVDD, LVEF, and LVFS. Multiple linear regression analysis revealed that the effects of 24h-DBPL and D-DBPL on MRA were statistically significantly different (P < 0.05).

CONCLUSIONS

Ambulatory BPL, particularly 24h-DBPL and D-DBPL, significantly affected MR. Therefore, controlling BPL, especially DBPL, was essential for reducing the incidence of cardiovascular events and clinical mortality in CAPD patients.