Relationship between non-dipper hypertension with presystolic wave and left atrial functions
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
Keywords
echocardiography , hypertension , left atrial function , left ventricular function
Kaynakça
- 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.)
