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 myocard ial infarction and to correlate its characteristics with parameters of syst olic left ventricular function. Material and methods. 40 patients with acut e myocardial infarction with left ventricular election fraction below 40% a nd symptoms of left ventricular failure (Killip class 1-2). Blood pressure monitoring and echocardiography for assessment of the left ventricular func tion were carried out on days 3-4 of infarction while patients were on stan dard therapy. Patients receiving angiotensin converting enzyme inhibitors o r nitroglycerine infusion were not included. Results. 24-hour blood pressur e profile on days 3-4 of myocardial infarction in 82% of patients receiving standard drug therapy was monophasic (24-hour index <10%, <<non-dipper>> c ategory). Remaining 18% of patients belonged to <<dipper>> (10%) and <<nigh t-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 r eflecting insufficient nocturnal blood pressure decline. 24 hour and nightt ime variability of systolic blood pressure, daytime and nighttime variabili ty of diastolic blood pressure directly closely correlated with end diastol ic volume (r=0,524; 0,533; 0,536; 0,510, p=0,007; p=0,005; p=0,005; p=0,009 , respectively).