Evaluation of the effect of dipping pattern in hypertensive patients on the left ventricular systolic functions by two-dimensional strain analysis.
BACKGROUND
Nondipping blood pressure pattern carry a high risk of cardiovascular and cerebrovascular complications due to a higher cumulative pressure overload. We aimed to define the role of strain analysis for detecting subclinical left ventricular systolic dysfunction in recently diagnosed nondipper and dipper hypertensive patients with normal left ventricular systolic function.


METHODS
Study population consisted of two groups of patients, Group 1: 45 dipper patients and Group 2: 43 nondipper patients. Global and segmental two-dimensional longitudinal strain analysis were measured by speckle tracking method.


RESULTS
The analysis of two-dimensional left ventricular global longitudinal strain and strain rates showed that there was a significant difference between groups (-18.1%±3.1% for nondippers vs -20.5%±2.4% for dippers, P<.001 for global longitudinal strain and -1.2±0.2 1/s for nondippers vs -1.31±0.16 1/s for dippers, P<.001 for global longitudinal strain rate). The nighttime systolic, diastolic, and mean blood pressure measurements were significantly higher in the nondipper group. Nocturnal dipping rates were statistically different between the groups (P<.001). Interventricular septum, posterior wall thickness, relative wall thickness, left atrial dimension, left ventricular mass, and mass index were higher in the nondipper group. Multivariate analysis demonstrated left atrium size, nocturnal dipping rate, daytime mean blood pressure, and nighttime systolic, diastolic, and mean blood pressure as independent predictors of global longitudinal strain.


CONCLUSIONS
In our study, two-dimensional speckle tracking examination showed that the left ventricular systolic function is impaired even in the subclinical period in recently diagnosed nondipper hypertensive patients with deformational analysis.
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Hüseyin
http://orcid.org/0000-0003-0700-8155
H
Göksülük
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Ulvin
U
Habibova
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Aydan
A
Ongun
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Müge
M
Akbulut
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Nil
N
Özyüncü
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Türkan Seda Tan
TST
Kürklü
Cardiology Department, Avicenna Hospital, Ankara University, Ankara, Turkey.
Cetin
C
Erol
D001794:Blood Pressure; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*
left ventricular function; left ventricular remodeling; myocardial strain; strain-strain rate