Left ventricular diastolic function and circadian variation of blood pressure in essential hypertension
M Aydin, A Ozeren, M Bilge, H Atmaca, M Unalacak, A Dursun, MA Elbey
article (Uluslararası, Hakemli) | Yazar(lar): M Aydin, A Ozeren, M Bilge, H Atmaca, M Unalacak, A Dursun, MA Elbey | Yıl: 2005 | Dergi/Kurum: TEXAS HEART INSTITUTE JOURNAL | İndeks: WOS.SCI | Anahtar Kelimeler: blood pressure, circadian rhythm, echocardiography, Doppler, electrocardiography, ambulatory, hypertension —
The purpose of this prospective study was to determine the relationship between circadian blood pressure and left ventricular diastolic function in essential hypertension
. The study population included 25 patients aged 56 18 years with non-dipper hypertension and 25 age- and sex-matched patients with dipper hypertension. They underwent conventional Doppler echocardiography and color tissue Doppler from apical 4- and 2-chamber views.
In non-dipper patients, diastolic left ventricular function was reduced significantly The transmitral E wave decreased (0.55 +/- 0.2 vs 0.62 +/- 0.2 m/s, P < 0.05), the transmitral A wave increased (0.77 +/- 0.1 vs 0.70 +/- 0.1 m/s, P < 0.01), the transmitral E/A ratio decreased (0.78 +/- 0.1 vs 0.86 +/- 0.2 P < 0. 05), and the transmitral E-wave deceleration time increased in non-dipper patients (211 +/- 44 vs 196 +/- 42 ms, P < 0.05). The isovolumic relaxation time increased (112 +/- 15 vs 105 +/- 14 m/s, P < 0.05). The mean left ventricular myocardial velocities also differed significantly; the early diastolic velocity decreased (5.9 +/- 2.1 vs 77 +/- 3.1 cm/s, P < 0.01), the late diastolic velocity increased (9.5 +/- 2.7 vs 8.7 +/- 1.6 cm/s, P < 0.05), and the E/A ratio decreased (0.68 +/- 0.55 vs 0.94 +/- 0.39, P < 0.01).
These findings suggest that non-dipper hypertensive patients who have impaired left ventricular diastolic function should be identified early for careful follow-up and possible referral to a specialized center.