Yeni Tanı Dipper ve Non-dipper Hipertansif Hastalarda Strain Analiz Metoduyla Sol Ventrikül Global Sistolik Fonksiyonlarının Değerlendirilmesi

Abstract

Objective: Non-dipper hypertension has been associated with enhanced target organ damage and adverse cardiovascular outcomes. The effect of dipper and non-dipper status on cardiac target organ damage has not been comprehensively investigated by two-dimensional (2D) strain echocardiography. We aimed to investigate myocardial deformational strain parameters in dipper and non-dipper untreated hypertensive patients. Material and Methods: We included 42 newly diagnosed hypertensive patients without a previous history of cardiovascular disease and coexisting chronic disease. Study population consisted of two groups of patients, 23 dipper patients and 19 non-dipper patients. Global longitudinal strain (GLS), radial strain and circumferential strain analysis were measured by 2D speckle tracking method. Results: The study population included 42 patients (15 male) with a mean age of 54.5±9 years. The assessment of left ventricular (LV) systolic function by GLS showed decreased values in non-dippers compared with dippers (-18.13±2.07 vs. -13.7±1.95; p=0.001). But no significant intergroup differences were observed in circumferential and radial strain. The analysis showed that night-time mean arterial pressure (MAP), nighttime systolic and diastolic blood pressures, 24-hr systolic blood pressure, dipping rate and nocturnal reduction rate of MAP were the parameters that correlated with GLS. Only dipping rate was independently associated with LV GLS. Conclusion: An isolated non-dipper BP was found to cause impaired LV systolic function detected by myocardial strain.