Evaluation of Left Ventricular and Left Atrial Functions with Strain and Strain Rate Echocardiography in Patients with Nondipper and Dipper Hypertension

Abstract

Objectives: Nondippers hypertension (NDHT) are known to carry a high risk of cardiovascular morbidity and mortality.The aim of this study was to investigate the effects of dipper (DHT) and nondipper status of hypertension on left atrial(LA), left ventricle (LV) systolic and diastolic functions using two-dimensional echocardiography (2D), tissue Dopplerimages (TDI) and strain imaging.Methods: A total of 60 patients and 20 healthy individuals were included in the study. The patients were separated twogroups that dipper and nondippers (if their daytime ambulatory systolic and diastolic blood pressure did not decreaseby at least 10% during the night). Left ventricle and LA strain values, diastolic function were obtained by 2D with automated software and compared between the groups.Results: Demographic variables of the groups were similar in our study.(such as age, gender, smoker, body mass index, lipid profile) Diastolic functions significantly impaired in NDHT group (E velocity and E/A ratio were significantlyreduced, A velocity a significantly increased, p<0.005). Tissue Doppler measurements; Lateral Sm, Em, Septal Em weresignificantly reduced in NDHT group (p<0.005). Strain parameters of patients was seen to be significantly reduced inNDHT group (LV lateral S, LV septal S, LA lateral S, LA septal S, p<0,005).Conclusion: Patients with nondipper hypertension have decreased LV diastolic function, significantly changes of tissue Doppler and analysis of left ventricule and atrial strain, in comparison with dipper group. In our study, both atrialand ventricular strain evaluations were found to be significantly impaired in the NDHT group at the same time. Consequently LV-LA strain can be used for the assessment early knowledge of the target organ damage in patients withnondipper hypertension.