title: Echocardiographic indices of left ventricular hypertrophy and diastolic function in hypertensive patients with preserved LVEF classified as dippers and non-dippers.
abstract: BACKGROUND
  Long-lasting arterial hypertension causes left ventricular hypertrophy (LVH) and impairs left ventricular diastolic function. Our aim was to compare echocardiographic parameters between hypertensive patients defined as dippers and non-dippers during ambulatory blood pressure (BP) monitoring.
  
  
  METHODS
  We analysed 61 consecutive subjects with treated hypertension undergoing 24-h BP monitoring and transthoracic echocardiographic examination and included in the study patients with preserved left ventricular ejection fraction (EF ≥ 50%). Echocardiographic and arterial pressure parameters were compared between the group classified as dippers (n = 26, 57 ±13 years, 16 males) and non-dippers (n = 35, 60 ±12 years, 24 males) according to present or absent decrease of BP during the night > 10%. Echocardiographic data were compared between both groups and control subjects without hypertension.
  
  
  RESULTS
  Dippers had lower average systolic, diastolic and mean arterial pressure during the night hours but did not differ according to the mean pressure calculated from a 24-hour period. All echocardiographic parameters were similar in dippers and non-dippers. All patients with arterial hypertension presented with larger dimension of both ventricles and left atrium, thicker left ventricular walls, higher LV mass and mass index and preserved EF and E/A ratio as compared with normotensive controls. Normal geometry, concentric remodelling and eccentric hypertrophy were similarly distributed in both groups. Concentric hypertrophy was more prevalent in non-dippers as compared to the dippers (71.4% vs. 38.5%, p < 0.043).
  
  
  CONCLUSIONS
  The concentric type of LVH is the prevalent pattern in non-dippers. Non-dipping blood pressure pattern may be responsible for the development of left ventricular concentric hypertrophy secondary to hypertension.
authors.affiliation: 2 Chair and Department of Cardiology, Medical University of Lodz, Poland ; Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Możdżan
authors.forename: Karina
authors.initials: K
authors.lastname: Wierzbowska-Drabik
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kurpesa
authors.forename: Ewa
authors.initials: E
authors.lastname: Trzos
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rechciński
authors.forename: Marlena
authors.initials: M
authors.lastname: Broncel
authors.forename: Jarosław D
authors.initials: JD
authors.lastname: Kasprzak
keywords: ambulatory blood pressure monitoring; echocardiography