title: Left ventricular diastolic function and circadian variation of blood pressure in essential hypertension.
abstract: The purpose of this prospective study was to determine the relationship between circadian blood pressure and left ventricular diastolic function in essential hypertension. The study population included 25 patients aged 56 +/- 18 years with non-dipper hypertension and 25 age- and sex-matched patients with dipper hypertension. They underwent conventional Doppler echocardiography and color tissue Doppler from apical 4- and 2-chamber views. In non-dipper patients, diastolic left ventricular function was reduced significantly. The transmitral E wave decreased (0.55 +/- 0.2 vs 0.62 +/- 0.2 m/s, P < 0.05), the transmitral A wave increased (0.77 +/- 0.1 vs 0.70 +/- 0.1 m/s, P < 0.01), the transmitral E/A ratio decreased (0.78 +/- 0.1 vs 0.86 +/- 0.2, P < 0.05), and the transmitral E-wave deceleration time increased in non-dipper patients (211 +/- 44 vs 196 +/- 42 ms, P < 0.05). The isovolumic relaxation time increased (112 +/- 15 vs 105 +/- 14 m/s, P < 0.05). The mean left ventricular myocardial velocities also differed significantly; the early diastolic velocity decreased (5.9 +/- 2. 1 vs 77 +/- 3.1 cm/s, P < 0.01), the late diastolic velocity increased (9.5 +/- 2.7 vs 8.7 +/- 1.6 cm/s, P < 0.05), and the E/A ratio decreased (0.68 +/- 0.55 vs 0.94 +/- 0.39, P < 0.01). These findings suggest that non-dipper hypertensive patients who have impaired left ventricular diastolic function should be identified early for careful follow-up and possible referral to a specialized center.
authors.affiliation: Department of Cardiology, School of Medicine, Zonguldak Karaelmas University, Kozlu 67600, Zonguldak, Turkey. drmustafaaydin@hotmail.com
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydin
authors.forename: Ali
authors.initials: A
authors.lastname: Ozeren
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bilge
authors.forename: Hulusi
authors.initials: H
authors.lastname: Atmaca
authors.forename: Murat
authors.initials: M
authors.lastname: Unalacak
authors.forename: Aydin
authors.initials: A
authors.lastname: Dursun
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Elbey
mesh_terms: D001794:Blood Pressure; D002940:Circadian Rhythm; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016277:Ventricular Function, Left