Mitral Annulus Posterior Systolic Excursion Instead of Left Ventricular Ejection Fraction to Evaluate Left Ventricular Systolic Function Both During Urgent Hypertensive Crisis and After Blood Pressure Normalization

摘要

Hypertensive crisis (HC) consists of a sudden increase in systolic-diastolic blood pressure. It may be divided into two categories: emergency and urgency HCs, depending on the impairment of target organs' dysfunction or not. Both during emergency or urgency HC, the left ventricle is unable to perform its normal function. Left ventricular (LV) systolic function is usually assessed by percentage of LV ejection fraction (LVEF%), but the Mitral Annulus Posterior Systolic Excursion (MAPSE) may also be used. Specifically, MAPSE seems to reflect the contribution of the longitudinally oriented myocardial fibers in generating LV stroke volume. LVEF% decreased during urgent HC, for LV dysfunction because of sudden growth of afterload, depending on peripheral vasocon-striction, activation of the nervous system, and activation of the renin-angiotensin-aldosterone system.