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Non-dipper hipertansiyon ile presistolik dalga ve sol atriyum fonksiyonları arasındaki ilişki

Year 2021, , 1500 - 1507, 30.12.2021
https://doi.org/10.17826/cumj.979153

Abstract

Amaç: Bu çalışmanın amacı presistolik dalga (PSD) varlığı ve non-dipper hipertansiyon arasındaki ilişkiyi araştırmaktır. Ayrıca PSD oluşumuna sol atriyum fonksiyonlarındaki değişimin etkisi olup olmadığı araştırılması amaçlanmıştır.
Gereç ve Yöntem: Bu kesitsel çalışmaya 77 dipper ve 43 non-dipper hipertansiyonu olan 120 hasta dahil edildi. Dipper ve non-dipper hipertansiyon grupları, PSD varlığı ve sol atriyum fonksiyon ekokardiyografik parametreleri açısından birbirleriyle karşılaştırıldı.
Bulgular: Sol atriyum aktif boşalma fraksiyonu (SAABF) (38.6 ± 2.8’ e karşı 35.1 ± 3.3) ve PSD insidansı (%69.8’ e karşı %37.7) non-dipper hipertansiyon grubunda dipper hipertansiyon grubuna göre anlamlı olarak daha yüksekti. Yaş, miyokardiyal pik erken diyastolik hız (Em), sol atriyum minimum hacmi, SAABF (odds oranı = 1.719, 95% güven aralığı = 1.367–2.162) ve PSD (odds oranı = 7.116, 95% güven aralığı = 2.063–24.548) non-dipper hipertansiyonun bağımsız öngördürücüleri olarak bulundu. Presistolik dalgası olan ve olmayanlar içinde non-dipper hipertansiyon ve dipper hipertansiyonu olan gruplar SAABF’ sine göre karşılaştırıldığında non-dipper hipertansiyon grubunda SAABF anlamlı olarak daha yüksek izlendi.
Sonuç: PSD'nin varlığı hipertansiyonu hastalarında daha yüksek riskli olan non-dipper grubun kolayca saptanmasında fayda sağlayabilir. Bu hasta grubunda PSD' nin daha sıklıkla oluşumu diyastolik dolumu korumak için artmış sol atriyum kasılmasından bağımsızdır.

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References

  • Referans1. Dinh QN, Drummond GR, Sobey CG, Chrissobolis S. Roles of inflammation, oxidative stress, and vascular dysfunction in hypertension. Biomed Res Int. 2014; 2014:406960
  • Referans2. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002; 20(11): 2183-9.
  • Referans3. Cuspidi C, Meani S, Salerno M, Valerio C, Fusi V, Severgnini B, Lonati L, Magrini F, Zanchetti A.Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure. J Hypertens. 2004;22(2):273-80.
  • Referans4. Chen Y, Liu JH, Zhen Z, Zuo Y, Lin Q, Liu M, Zhao C, Wu M, Cao G, Wang R, Tse HF, Yiu KH. Assessment of left ventricular function and peripheral vascular arterial stiffness in patients with dipper and non-dipper hypertension. J Investig Med. 2018; 66(2):319-324
  • Referans5. Verdecchia P, Schillaci G, Guerrieri M, Gatteschi C, Benemio G, Boldrini F, Porcellati C. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990; 81(2): 528-36.
  • Referans6. Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002; 90(12): 1284-9.
  • Referans7. Suh IW, Song JM, Lee EY, Kang SH, Kim MJ, Kim JJ, Kang DH, Song JK. Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. J Am Soc Echocardiogr. 2008; 21(5): 439-45.
  • Referans8. Benjamin EJ, D'Agostino RB, Belanger AJ, Wolf PA, Levy D. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation. 1995; 92(4): 835-41.
  • Referans9. Aydın M, Özeren A, Bilge M, Dursun A, Cam F, Elbey MA. Effects of dipper and non-dipper status of essential hypertension on left atrial mechanical functions. Int J Cardiol 2004; 96: 419-24.
  • Referans10. Ermiş N, Otlu YÖ, Afşin A, Hidayet Ş, Açıkgöz N, Cansel M, Yağmur J, Çolak MC. Comparison of left atrial volume and function in non-dipper versus dipper hypertensives: A real-time three-dimensional echocardiography study. Anatol J Cardiol. 2016; 16(6): 428-33.)
  • Referans11. Mittal SR, Pancholi N. Left ventricular outflow tract presystolic flow velocity--another marker of left ventricular diastolic function. Int J Cardiovasc Imaging. 2002; 18(4): 249-56.
  • Referans12. Akyüz AR, Turan T, Gürbak İ, Korkmaz L, Ağaç MT, Çelik Ş. The relationship between presystolic wave and subclinical left ventricular dysfunction in asymptomatic hypertensive patients. Blood Press Monit. 2016; 21(5): 277-81.
  • Referans13. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021-3104.
  • Referans14. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, Horton K, Ogunyankin KO, Palma RA, Velazquez EJ. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019; 32(1): 1-64.
  • Referans15. Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographicassessment of left ventricular hypertrophy: comparison to necropsy finding. Am J Cardiol 1986;57:450-8.
  • Referans16. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233-70.
  • Referans17. Tadic M, Cuspidi C, Pencic-Popovic B, Celic V, Mancia G. The relationship between nighttime hypertension and left atrial function. J Clin Hypertens (Greenwich). 2017; 19(11):1096-1104.
  • Referans18. Hill JA, Olson EN. Cardiac plasticity. N Engl J Med. 2008 Mar 27; 358(13): 1370-80.
  • Referans19. Aydin M, Ozeren A, Bilge M, Atmaca H, Unalacak M, Dursun A, Elbey MA. Left ventricular diastolic function and circadian variation of blood pressure in essential hypertension. Tex Heart Inst J. 2005; 32(1): 28-34.
  • Referans20. Tigen K, Karaahmet T, Fotbolcu H, Gürel E, Cevik C, Geçmen C, Bitigen A, Mutlu B, Başaran Y. The influence of dipper and nondipper blood pressure patterns on left ventricular functions in hypertensive patients: a tissue Doppler study. Turk Kardiyol Dern Ars. 2009; 37(2): 101-6.
  • Referans21. Erdogan D, Gullu H, Caliskan M, Yildirim I, Baycan S, Ciftci O, Muderrisoglu H. The influence of circadian blood pressure changes on aortic distensibility and left ventricular diastolic function in hypertensive individuals. Int J Cardiovasc Imaging. 2006; 22(2): 157-65.
  • Referans22. Sokmen G, Sokmen A, Aksu E, Koroglu S, Suner A, Tuncer C. The influence of ambulatory blood pressure profile on global and regional functions of the left and the right ventricles in orderly treated hypertensive patients. Echocardiography. 2008; 25(5): 465-72.
  • Referans23. Matsuda M, Matsuda Y. Mechanism of left atrial enlargement related to ventricular diastolic impairment in hypertension. Clin Cardiol. 1996; 19(12): 954-9.
  • Referans24. Spencer KT, Mor-Avi V, Gorcsan J 3rd, DeMaria AN, Kimball TR, Monaghan MJ, Perez JE, Weinert L, Bednarz J, Edelman K, Kwan OL, Glascock B, Hancock J, Baumann C, Lang RM. Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study. Heart. 2001; 85(3): 272-7.
  • Referans25. Triposkiadis F, Tentolouris K, Androulakis A, Trikas A, Toutouzas K, Kyriakidis M, Gialafos J, Toutouzas P. Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr. 1995; 8(6): 801-9.
  • Referans26. Kagawa K, Arakawa M, Miwa H, Noda T, Nishigaki K, Ito Y, Hirakawa S. Left atrial function during left ventricular diastole evaluated by left atrial angiography and left ventriculography. J Cardiol. 1994; 24(4): 317-25.
  • Referans27. Hoit BD. Assessment of echocardiographic left atrial size: how accurate do we need to be? JACC Cardiovasc Imaging. 2012; 5(8): 778-80.
  • Referans28. Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, Di Tullio MR. Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function. Heart. 2012; 98(10): 813-20.
  • Referans29. Kahyaoglu M, Bayam E, Gunay N, Gecmen C, Candan O, Yilmaz Y, Guner A, Celik M, Cakmak EO, Uyan C.The relationship between presystolic wave and nondipper hypertension. Blood Press Monit. 2020; 25(3): 142-146.

Relationship between non-dipper hypertension with presystolic wave and left atrial functions

Year 2021, , 1500 - 1507, 30.12.2021
https://doi.org/10.17826/cumj.979153

Abstract

Purpose: This study aims to investigate the relationship between presystolic wave (PSW) and non-dipper hypertension. In addition, it was aimed to investigate whether the change in left atrial functions affects PSW.
Materials and Methods: 120 patients with 77 dipper hypertension and 43 non-dipper hypertension were included in this cross-sectional study. Dipper and non-dipper hypertension groups were compared with each other in terms of PSW presence and echocardiographic parameters of the left atrial function.
Results: Left atrial active emptying fraction (LAAEF) (38.6 ± 2.8 vs. 35.1 ± 3.3) and PSW incidence (69.8% vs. 37.7%) were significantly higher in the non-dipper hypertension group than in the dipper hypertension group. Age, myocardial peak early diastolic velocity (Em), left atrial minimum volume, LAAEF (odds oranı = 1.719, 95% Confidence Interval = 1.367–2.162) and PSW (odds oranı = 7.116, 95% Confidence Interval = 2.063–24.548) were found to be independent predictors of non-dipper hypertension. When the groups with non-dipper hypertension and dipper hypertension were compared with and without presystolic waves, LAAEF was found to be significantly higher in the non-dipper hypertension group.
Conclusion: The presence of PSW may be beneficial in easily detecting the non-dipper group, which has a higher risk in hypertension patients. The more frequent occurrence of PSW in this patient group is independent of increased left atrial contraction to maintain diastolic filling

References

  • Referans1. Dinh QN, Drummond GR, Sobey CG, Chrissobolis S. Roles of inflammation, oxidative stress, and vascular dysfunction in hypertension. Biomed Res Int. 2014; 2014:406960
  • Referans2. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertens. 2002; 20(11): 2183-9.
  • Referans3. Cuspidi C, Meani S, Salerno M, Valerio C, Fusi V, Severgnini B, Lonati L, Magrini F, Zanchetti A.Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure. J Hypertens. 2004;22(2):273-80.
  • Referans4. Chen Y, Liu JH, Zhen Z, Zuo Y, Lin Q, Liu M, Zhao C, Wu M, Cao G, Wang R, Tse HF, Yiu KH. Assessment of left ventricular function and peripheral vascular arterial stiffness in patients with dipper and non-dipper hypertension. J Investig Med. 2018; 66(2):319-324
  • Referans5. Verdecchia P, Schillaci G, Guerrieri M, Gatteschi C, Benemio G, Boldrini F, Porcellati C. Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension. Circulation. 1990; 81(2): 528-36.
  • Referans6. Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002; 90(12): 1284-9.
  • Referans7. Suh IW, Song JM, Lee EY, Kang SH, Kim MJ, Kim JJ, Kang DH, Song JK. Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. J Am Soc Echocardiogr. 2008; 21(5): 439-45.
  • Referans8. Benjamin EJ, D'Agostino RB, Belanger AJ, Wolf PA, Levy D. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation. 1995; 92(4): 835-41.
  • Referans9. Aydın M, Özeren A, Bilge M, Dursun A, Cam F, Elbey MA. Effects of dipper and non-dipper status of essential hypertension on left atrial mechanical functions. Int J Cardiol 2004; 96: 419-24.
  • Referans10. Ermiş N, Otlu YÖ, Afşin A, Hidayet Ş, Açıkgöz N, Cansel M, Yağmur J, Çolak MC. Comparison of left atrial volume and function in non-dipper versus dipper hypertensives: A real-time three-dimensional echocardiography study. Anatol J Cardiol. 2016; 16(6): 428-33.)
  • Referans11. Mittal SR, Pancholi N. Left ventricular outflow tract presystolic flow velocity--another marker of left ventricular diastolic function. Int J Cardiovasc Imaging. 2002; 18(4): 249-56.
  • Referans12. Akyüz AR, Turan T, Gürbak İ, Korkmaz L, Ağaç MT, Çelik Ş. The relationship between presystolic wave and subclinical left ventricular dysfunction in asymptomatic hypertensive patients. Blood Press Monit. 2016; 21(5): 277-81.
  • Referans13. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021-3104.
  • Referans14. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, Horton K, Ogunyankin KO, Palma RA, Velazquez EJ. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019; 32(1): 1-64.
  • Referans15. Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographicassessment of left ventricular hypertrophy: comparison to necropsy finding. Am J Cardiol 1986;57:450-8.
  • Referans16. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233-70.
  • Referans17. Tadic M, Cuspidi C, Pencic-Popovic B, Celic V, Mancia G. The relationship between nighttime hypertension and left atrial function. J Clin Hypertens (Greenwich). 2017; 19(11):1096-1104.
  • Referans18. Hill JA, Olson EN. Cardiac plasticity. N Engl J Med. 2008 Mar 27; 358(13): 1370-80.
  • Referans19. Aydin M, Ozeren A, Bilge M, Atmaca H, Unalacak M, Dursun A, Elbey MA. Left ventricular diastolic function and circadian variation of blood pressure in essential hypertension. Tex Heart Inst J. 2005; 32(1): 28-34.
  • Referans20. Tigen K, Karaahmet T, Fotbolcu H, Gürel E, Cevik C, Geçmen C, Bitigen A, Mutlu B, Başaran Y. The influence of dipper and nondipper blood pressure patterns on left ventricular functions in hypertensive patients: a tissue Doppler study. Turk Kardiyol Dern Ars. 2009; 37(2): 101-6.
  • Referans21. Erdogan D, Gullu H, Caliskan M, Yildirim I, Baycan S, Ciftci O, Muderrisoglu H. The influence of circadian blood pressure changes on aortic distensibility and left ventricular diastolic function in hypertensive individuals. Int J Cardiovasc Imaging. 2006; 22(2): 157-65.
  • Referans22. Sokmen G, Sokmen A, Aksu E, Koroglu S, Suner A, Tuncer C. The influence of ambulatory blood pressure profile on global and regional functions of the left and the right ventricles in orderly treated hypertensive patients. Echocardiography. 2008; 25(5): 465-72.
  • Referans23. Matsuda M, Matsuda Y. Mechanism of left atrial enlargement related to ventricular diastolic impairment in hypertension. Clin Cardiol. 1996; 19(12): 954-9.
  • Referans24. Spencer KT, Mor-Avi V, Gorcsan J 3rd, DeMaria AN, Kimball TR, Monaghan MJ, Perez JE, Weinert L, Bednarz J, Edelman K, Kwan OL, Glascock B, Hancock J, Baumann C, Lang RM. Effects of aging on left atrial reservoir, conduit, and booster pump function: a multi-institution acoustic quantification study. Heart. 2001; 85(3): 272-7.
  • Referans25. Triposkiadis F, Tentolouris K, Androulakis A, Trikas A, Toutouzas K, Kyriakidis M, Gialafos J, Toutouzas P. Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity. J Am Soc Echocardiogr. 1995; 8(6): 801-9.
  • Referans26. Kagawa K, Arakawa M, Miwa H, Noda T, Nishigaki K, Ito Y, Hirakawa S. Left atrial function during left ventricular diastole evaluated by left atrial angiography and left ventriculography. J Cardiol. 1994; 24(4): 317-25.
  • Referans27. Hoit BD. Assessment of echocardiographic left atrial size: how accurate do we need to be? JACC Cardiovasc Imaging. 2012; 5(8): 778-80.
  • Referans28. Russo C, Jin Z, Homma S, Rundek T, Elkind MS, Sacco RL, Di Tullio MR. Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function. Heart. 2012; 98(10): 813-20.
  • Referans29. Kahyaoglu M, Bayam E, Gunay N, Gecmen C, Candan O, Yilmaz Y, Guner A, Celik M, Cakmak EO, Uyan C.The relationship between presystolic wave and nondipper hypertension. Blood Press Monit. 2020; 25(3): 142-146.
There are 29 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research
Authors

İbrahim Yıldız 0000-0002-2884-7970

İsmail Gürbak 0000-0001-8466-4354

Publication Date December 30, 2021
Acceptance Date September 26, 2021
Published in Issue Year 2021

Cite

MLA Yıldız, İbrahim and İsmail Gürbak. “Non-Dipper Hipertansiyon Ile Presistolik Dalga Ve Sol Atriyum Fonksiyonları arasındaki ilişki”. Cukurova Medical Journal, vol. 46, no. 4, 2021, pp. 1500-7, doi:10.17826/cumj.979153.