Presystolic Wave Velocity May Predict Aortic Stiffness but Not Circadian Blood Pressure Pattern in Patients With Newly Diagnosed Essential Hypertension

Background and Aim: Non-dipping circadian pattern and increased aortic stiffness have been linked to increased morbidity and mortality in patients with htpertension (HT). Our aim in the present study was to assess whether presystolic wave (PSW) velocity measured by Doppler transthoracic echocardiography (TTE) on left ventricular outflow tract (LVOT) had relationship with circadian pattern and the aortic stiffness parameters assessed by TTE. Methods: A total of 140 newly-diagnosed essential HT patients admitting to the cardiology outpatient polyclinic were consecutively included. Data regarding phisical examination, laboratory analysis, TTE, and ambulatory blood pressure monitoring (ABPM) were obtained retrospectively from medical records. Patients were divided into dipper (n=75) and non-dipper (n=65) groups on the basis of ABPM. Relationship of PSW velocity with circadian pattern and aortic stiffness was evaluated. Results: Peak PSW velocity was similar between dipper and non-dipper HT subgroups. Spearman’s correlation analysis showed a positive correlation of PSW velocity with aortic stiffness index (r=0.286; p=0.007), transmitral A velocity (r=0.260; p=0.017), E/A ratio (r=-0.265; p=0.015), and lateral E’ velocity (r=-0.279; p=0.013). In multivariate logistic regression model, aortic stiffness index (0.525, p<0.001), age (=0.239, p=0.009), lateral E/E’ ratio (0.636, p<0.001) and E/A ratio (-0.503, p<0.001) emerged as significant predictors of PSW velocity. Conclusion: Peak velocity of PSW on LVOT, if present, may provide information about the status of aortic stiffness and LV compliance assessed by TTE. However, PWS velocity is not useful in the prediction of circadian blood pressure pattern in newly-diagnosed essential HT patients.