Comparison of left atrial volume and function in non-dipper versus dipper hypertensives: A real-time three-dimensional echocardiography studyNecip Ermiş1, Yılmaz Ömür Otlu3, Abdülmecit Afşin1, Şıho Hidayet4, Nusret Açıkgöz1, Mehmet Cansel1, Jülide Yağmur1, M. Cengiz Çolak2
1Department of Cardiology and Turgut Özal Medical Center, İnönü University, Malatya-Turkey
2Cardiovascular Surgery, Turgut Özal Medical Center, İnönü University, Malatya-Turkey
3Clinic of Cardiology, Kars State Hospital, Kars-Turkey
4Clinic of Cardiology, Malatya State Hospital, Malatya-Turkey
Objective: Non-dipper hypertension is associated with an increased cardiovascular morbidity and mortality. Besides this, the left atrial (LA) size and functions are accepted to be prognostic factors in various cardiovascular diseases. In this study, we aimed to evaluate the effect of nondipper hypertension on LA volume and functions using real-time three-dimensional echocardiography (RT3-DE).Keywords: non-dipper hypertension, left atrial volume, real-time 3-D echocardiography
Methods: Forty dipper and 52 non-dipper hypertensives enrolled in this prospective cross-sectional study. Patients with any comorbidities that have a potential for causing structural cardiac alterations were excluded. Two-dimensional echocardiography (2-DE) and RT3-DE were performed to assess LA volumes and functions. The statistical tests used in this study were ShapiroWilks test, Students t-test, MannWhitney U test, chi-square test, Spearmans test, and Pearsons correlation test.
Results: LA minimal volume, LA volume before LA contraction, and LA total systolic volume were higher in non-dipper hypertensives than in dipper hypertensives (p<0.001, p=0.003, and p=0.03, respectively). Only, the 2-DE measurements of interventricular septal thickness and E/Em ratio were higher in non-dipper hypertensives (p=0.001 and p=0.03, respectively). There was a moderate correlation between LA minimal volume and LA volume before LA contraction with E/Em (r=0.31, p=0.007 and r=0.32, p=0.005, respectively).
Conclusion: Although LA volume and passive LA systolic functions measured by RT3-DE are significantly increased in non-dipper hypertensives, the alterations in active LA systolic functions are not prominent. RT-3DE may be used to define LA volume and function alterations in conditions that have capabilities of adverse cardiac remodeling such as systemic hypertension. (Anatol J Cardiol 2016; 16: 428-33)
Necip Ermiş, Yılmaz Ömür Otlu, Abdülmecit Afşin, Şıho Hidayet, Nusret Açıkgöz, Mehmet Cansel, Jülide Yağmur, M. Cengiz Çolak. Comparison of left atrial volume and function in non-dipper versus dipper hypertensives: A real-time three-dimensional echocardiography study. Anatol J Cardiol. 2016; 16(6): 428-433
Sorumlu Yazar: Necip Ermiş, Türkiye