Key result
Nondipper hypertension was associated with significantly lower mean left atrial appendage ejection velocity (47.7 vs 66.3 and 81.7 cm/sec) compared to dipper hypertension and controls (P<0.001).
Why the study?
Do patients with nondipper hypertension have lower left atrial appendage flow velocities compared to those with dipper hypertension and normal controls?
Cross-Sectional (n=73)
Do patients with nondipper hypertension have lower left atrial appendage flow velocities compared to those with dipper hypertension and normal controls?
Absolute Event Rate: 47.7% vs 81.7%
p-value: p=<0.001
Nondipper hypertension is associated with significantly decreased left atrial appendage flow velocities compared to dipper hypertension and normal controls, indicating impaired LAA function.
May suggest impaired LAA function in nondipper hypertension; leaves open any causal link to thromboembolism in cross-sectional data.
OBJECTIVE: In this study, left atrial appendage (LAA) flow velocities of dipper and nondipper hypertensive patients were compared with normal subjects. METHODS: Twenty-three patients with nondipper hypertension (NDH), 25 patients with dipper hypertension (DH), and 25 control subjects with comparable age, gender, and body mass indices were enrolled in the study. A detailed history, physical examination, and routine laboratory tests were obtained on all participants. Standard transthoracic echocardiographic examinations were performed on each subject. In addition, LAAs of all patients were visualized using transesophageal echocardiography. LAA filling and ejection velocities were measured using pulsed-wave Doppler with the sample volume placed in proximal third of the LAA. The mean LAA ejection velocity in patients with NDH (47.7 + 13.0 cm/sec) was found to be significantly lower relative to the DH (66.3 + 12.9 cm/sec) and the control group (81.7 + 8.0 cm/sec) (P < 0.001). The mean LAA filling velocity in patients with NDH (41.7 + 14.7 cm/sec) was also significantly lower relative to those observed in the DH 58.8 + 9.2 cm/sec) and the control group (67.2 + 7.9 cm/sec) (P<0.001). CONCLUSION: In NDH patients, LAA filling and ejection flow rates are decreased relative to DH patients and the control group. For patients with NDH detected using ambulatory blood pressure monitoring, more aggressive treatment approach should be considered. Maintenance of LAA function may prevent potential complications secondary to left atrial appendage dysfunction.
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Kumak et al. (2012) conducted a cross-sectional in Hypertension (n=73). Nondipper hypertension vs. Dipper hypertension and healthy controls was evaluated on Mean left atrial appendage ejection velocity (p=<0.001). Nondipper hypertension was associated with significantly lower mean left atrial appendage ejection velocity (47.7 vs 66.3 and 81.7 cm/sec) compared to dipper hypertension and controls (P<0.001).
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