title: Detection of atrial electrical and mechanical dysfunction in non-dipper pre-hypertensive subjects.
abstract: BACKGROUND
  A relationship between atrial conduction time and hypertension was shown in previous studies. Increased atrial electromechanical intervals used to predict atrial fibrillation by measured tissue Doppler imaging (TDI). So we aimed to search if there was any association between the non-dipping status and atrial electromechanical intervals in pre-hypertensive patients.
  
  
  METHODS
  Forty-one non-dipper and 33 dipper pre-hypertensive subjects enrolled in the study. Systolic and diastolic blood pressures were measured with a mercury sphygmomanometer. Twenty-four hours blood pressure was measured with cuff-oscillometric method. All patients were evaluated by transthoracic echocardiography. Using tissue Doppler imaging (TDI), atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid).
  
  
  RESULTS
  Systolic and diastolic blood pressures were significantly higher in subjects with non-dipper phenomenon than dipper ones at night. Twenty-four hours average systolic and diastolic blood pressures were higher in non-dipper pre-hypertensive subjects, but this elevation was not significant. Left and right intraatrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) electromechanical coupling intervals were measured significantly higher in non-dipper pre-hypertensive patients (31.3 ± 3.9 versus 24.1 ± 2.3, p = 0.001; 19.5 ± 4.3 versus 13.8 ± 2.1, p = 0.001; and 11.4 ± 2.8 versus 8.8 ± 1.5, p = 0.001). Also, interatrial electromechanical delay was negatively correlated with dipping levels.
  
  
  CONCLUSIONS
  This study showed that prolonged atrial electromechanical intervals were related non-dipper pattern in pre-hypertensive patients. Prolonged electromechanical intervals may be an early sign of subclinical atrial dysfunction and arrhythmias' in non-dipper pre-hypertensive patients.
authors.affiliation: Department of Cardiology .
authors.forename: Savas
authors.initials: S
authors.lastname: Sarıkaya
authors.forename: Safak
authors.initials: S
authors.lastname: Sahin
authors.forename: Serkan
authors.initials: S
authors.lastname: Oztürk
authors.forename: Lütfi
authors.initials: L
authors.lastname: Akyol
authors.forename: Fatih
authors.initials: F
authors.lastname: Altunkaş
authors.forename: Kayıhan
authors.initials: K
authors.lastname: Karaman
authors.forename: Aytekin
authors.initials: A
authors.lastname: Alcelik
authors.forename: Yunus
authors.initials: Y
authors.lastname: Keser Yılmaz
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000294:innervation / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058246:Prehypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Arrhythmias; atrial conduction time; doppler; non-dipping; pre-hypertension