title: Does a nondipping pattern influence left ventricular and left atrial mechanics in hypertensive patients?
abstract: OBJECTIVE
  The aim of this study was to determine left ventricular and left atrial function in untreated hypertensive patients with different blood pressure (BP) patterns by using two-dimensional echocardiography (2DE) and three-dimensional echocardiography (3DE) speckle tracking analyses.
  
  
  METHODS
  This cross-sectional study included 147 recently diagnosed hypertensive patients (86 dippers and 61 nondippers). All patients underwent a 24-h ambulatory BP monitoring and complete 2DE and 3DE examination including speckle tracking analysis.
  
  
  RESULTS
  The analysis of our results showed that 3DE left ventricular global longitudinal strain was significantly lower in the nondippers (-17.8 ± 2.6 vs. -16.2 ± 2.4%, P < 0.001). Similar results were obtained for 3DE left ventricular global circumferential strain (-17.4 ± 2.7 vs. -16.3 ± 2.6%, P = 0.015), as well for 3DE left ventricular global radial strain (45.8 ± 8.5 vs. 42.1 ± 8.2%, P = 0.009), and left ventricular global area strain (-29.1 ± 4.7 vs. -27.4 ± 4.3%, P = 0.027). The left ventricular twist was increased in the nondippers (12.7 ± 2.9 vs. 14.1 ± 3.4°, P = 0.008), whereas the untwisting rate was significantly decreased in this group (-43.7 ± 5.7 vs. -36.9 ± 5.1 °/s, P < 0.001). The left atrial longitudinal strain, as well as left atrial systolic and early diastolic strain rates, was decreased in nondippers. Independent predictors of 3DE left ventricular longitudinal, circumferential, radial, and area strain were a 24-h mean BP, (E/e')m, and 3DE left ventricular ejection fraction. An additional independent predictor of the left atrial longitudinal strain was 3DE left ventricular mass index.
  
  
  CONCLUSIONS
  The 3DE speckle tracking examination demonstrated that the left ventricular and left atrial mechanics were more impaired in the nondippers than in the dippers untreated hypertensive patients.
authors.affiliation: aUniversity Clinical Hospital Center 'Dr Dragisa Misovic', Belgrade, Serbia bClinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy cClinic of Cardiology, Clinical Centre of Serbia dFaculty of Medicine, University Clinical Hospital Center 'Dr Dragisa Misovic', Belgrade, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Anka
authors.initials: A
authors.lastname: Majstorovic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sljivic
authors.forename: Biljana
authors.initials: B
authors.lastname: Pencic
authors.forename: Branislava
authors.initials: B
authors.lastname: Ivanovic
authors.forename: Radisav
authors.initials: R
authors.lastname: Scepanovic
authors.forename: Vesna
authors.initials: V
authors.lastname: Kocijancic
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*