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Evaluation of the effect of dipping pattern in hypertensive patients on the left ventricular systolic functions by two‐dimensional strain analysis
Author(s) -
Göksülük Hüseyin,
Habibova Ulvin,
Ongun Aydan,
Akbulut Müge,
Özyüncü Nil,
Kürklü Türkan Seda Tan,
Erol Cetin
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13516
Subject(s) - cardiology , medicine , dipper , interventricular septum , blood pressure , speckle tracking echocardiography , subclinical infection , diastole , ambulatory blood pressure , population , ventricle , ejection fraction , heart failure , environmental health
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. Conclusion 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.