Key result
Nondipper hypertension associates with ~36% lower LA global strain and increased stiffness versus dipper hypertension.
Why the study?
Nondipper hypertension is associated with increased cardiovascular morbidity and mortality, and early detection of left atrial myocardial dysfunction using speckle tracking echocardiography is promising but not well established.
Does nondipper hypertension worsen left atrial mechanical function and stiffness compared to dipper hypertension?
Observational (n=80)
Does nondipper hypertension worsen left atrial mechanical function and stiffness compared to dipper hypertension?
Absolute Event Rate: 25.3% vs 39.6%
p-value: p=<0.001
Nondipper hypertension is associated with early left atrial myocardial dysfunction and increased stiffness compared to dipper hypertension, detectable by speckle tracking echocardiography.
Should not yet change hypertension management; hypothesis-generating for nondipper links to LA dysfunction.
BACKGROUND: Nondipper hypertension is associated with increased cardiovascular morbidity and mortality. Speckle tracking echocardiography is a novel and promising tool for detecting early changes in left atrial (LA) myocardial dysfunction. Our aim was to evaluate the LA mechanical function and stiffness in nondipper hypertensive patients by two-dimensional speckle tracking echocardiography strain parameters. METHOD: This study included 80 hypertensive patients. Hypertensive patients were divided into two groups: 50 dipper patients (29 male, mean age 51.5 ± 8 years) and 30 nondipper patients (17 male, mean age 50.6 ± 5.4 years). LA volume indices, mitral annular velocities, and global longitudinal LA strain were measured. The ratio of E/e' to LA strain was used as an index of LA stiffness. RESULTS: Patients with nondipper hypertension showed increased LA volume indices and decreased LA global strain (25.3 ± 5.5 vs. 39.6 ± 9.9%, P < 0.001). LA stiffness was increased in patients with nondipper than in the dipper subjects (0.41 ± 0.15 vs. 0.19 ± 0.14, P < 0.001), and LA strain and LA stiffness were related to LA volume indices. CONCLUSION: Patients with nondipper hypertension have decreased LA global strain and increased stiffness, in comparison with dipper group. LA stiffness and LA strain were significantly related to LA volume indices. LA stiffness and LA strain can be used for the assessment of LA function in patients with nondipper hypertension.
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Demir et al. (2017) conducted an observational in Hypertension (n=80). Nondipper hypertension vs. Dipper hypertension was evaluated on Left atrial global strain (p=<0.001). Nondipper hypertension was associated with decreased left atrial global strain (25.3% vs 39.6%, P<0.001) and increased left atrial stiffness compared to dipper hypertension.
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