Comparison of subclinical left and right ventricular systolic dysfunction in non-dipper and dipper hypertensives: impact of isovolumic acceleration.
Abstract Objectives: To evaluate subclinical left ventricular and right ventricular systolic impairment in dipper and non-dipper hypertensives by using isovolumic acceleration.


METHODS
About 45 normotensive healthy volunteers (20 men, mean age 43 ± 9 years), 45 dipper (27 men, mean age 45 ± 9 years) and 45 non-dipper (25 men, 47 ± 7 years) hypertensives were enrolled. Isovolumic acceleration was measured by dividing the peak myocardial isovolumic contraction velocity by isovolumic acceleration time.


RESULTS
Non-dippers indicated lower left ventricular (2.2 ± 0.4 m/s(2) versus 2.8 ± 1.0 m/s(2), p < 0.01) and right ventricular isovolumic acceleration values (2.8 ± 0.8 m/s(2) versus 3.5 ± 1.0 m/s(2), p = 0.012) compared with dippers. Left ventricular mass index (p = 0.001), interventricular septal thickness (p = 0.002) and myocardial performance index (p < 0.001) were negatively correlated with left ventricular isovolumic acceleration. Left ventricular septal thickness (p = 0.002), mass index (p = 0.001) and right ventricular myocardial performance index (p < 0.001) were negatively correlated with right ventricular isovolumic acceleration.


CONCLUSIONS
The present study demonstrates that non-dipper hypertensives have increased left and right ventricular subclinical systolic dysfunction compared with dippers. Isovolumic acceleration is the only echocardiographic parameter in predicting this subtle impairment.
Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital , Istanbul , Turkey .
Mehmet
M
Erturk
Ali
A
Buturak
Hamdi
H
Pusuroglu
Ali Kemal
AK
Kalkan
Muhammet
M
Gurdogan
Ibrahim Faruk
IF
Akturk
Ozgur
O
Akgul
Hale Unal
HU
Aksu
Fatih
F
Uzun
Nevzat
N
Uslu
D000054:Acceleration; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002940:Circadian Rhythm; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D055815:Young Adult
Dipper; isovolumic acceleration; non-dipper