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Objective: Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. The purpose of this study was to evaluate the association of non-dipping hypertension with aortic diameter in patients with metabolic syndrome. Materials and Methods:This study included 70 hypertensive patients with metabolic syndrome. These patients were evaluated with 24-h blood pressure Holter monitoring and divided into two groups of 35 patients each. Aortic diameter was measured by M-mode and two-dimensional echocardiography. These parameters were compared between the two groups. Results:In the dipper group, there were 26 female and 9 male patients with a mean age of 55±11 years. In the non-dipper group, there were 25 female and 10 male patients with a mean age of 56±11 years. No significant difference was found between the two groups in terms of basic characteristics. Non-dipper hypertensive patients had a higher thoracic aortic diameter value than dipper patients (35.6±2.4 and 33.23±1.1, p<0.01). Conclusion:These findings suggest that thoracic aortic diameter value is higher in patients with non-dipper hypertension.Key Words: Blood pressure, metabolic syndrome, aortic diameter, echocardiography, non-dipper Özet Amaç: Non-dipper hipertansiyon artmış kardiyovasküler mortalite ve morbidite ile ilişkilidir. Bu çalışmanın amacı metabolik sendromlu hastalarda aort çapı ile non-dipping hipertansiyon ilişkisini değerlen-dirmektir. Gereç ve Yöntem:Çalışmaya metabolik sendromlu 70 hipertansif hasta alındı. Bu hastaların 24 saat kan basıncı ölçümü holter ile değerlen-dirildi ve herbirinde 35 hasta olan iki gruba ayrıldı. Aort çapları M mod ve iki boyutlu ekokardiyografi ile değerlendirildi. Bu paramatreler iki gurup arasında karşılaştırıldı. Bulgular:Dipper gurupta yaş ortalaması 55±11 yıl olan 26 kadın, 9 erkek hasta vardı. Non-dipper gurupta yaş ortalaması 56±11 yıl olan 25 kadın, 10 erkek hasta vardı. Temel özellikler açısından iki gurup arasında anlamlı farklılık yoktu. Non-dipper gurupta torasik aort çapları dipper guruba göre yüksekti (35.6±2.4 and 33.23±1.1, p<0.01).Sonuç: Bu bulgular non-dipper hipertansiyon hastalarında torasik aort çaplarının yüksek olduğunu göstermiştir.Anahtar Kelimeler: Kan basıncı, metabolik sendrom, aort çapı, ekokardiyografi, non-dipper

The interatrial conduction time can be estimated with a relatively noninvasive method using P-LAA measurements. This technique can be applied widely in predicting AF recurrence, and appropriate therapy may be applied.

Left atrial (LA) volumes were measured echocardiographically in 32 MS patients and 32 age- and sex-matched controls. LA volumes were determined at the time of mitral valve opening (maximal, Vmax), at the onset of atrial systole (p wave on the electrocardiogram, Vp) and at the mitral valve closure (minimal, Vmin) according to the biplane area-length method in apical 4-chamber and 2-chamber view. All volumes were corrected to the body surface area, and following left atrial emptying functions were calculated. LA passive emptying volume =Vmax- Vp LA passive emptying fraction = LA passive emptying volume/Vmax . Conduit volume= LV stroke volume - (Vmax- Vmin), LA active emptying volume =Vp- Vm,, LA active emptying fraction= LA active emptying volume/Vp, LA total emptying volume = (Vmax -Vmin), LA total emptying fraction = LA total emptying volume/Vmax. RESUITS: LA maximal volume and LA presystolic volume were significantly higher in MS patients than in controls (P <0.001). But LA minimum volume was significantly lower in MS patients than in controls (P <0.001). Although LA passive emptying volume (P <0.03), LA passive emptying fraction (P <0.001) and conduit volume (P <0.001) were found to be significantly lower in MS patients than in controls, LA active emptying volume (P <0.001) and LA active emptying fraction (P< 0.001) were significantly greater in MS patients than in controls. Conclusion In our study, metabolic syndrome was associated with increased left atrial volume, decreased left atrial passive emptying function and increased pump function. Increased left atrial pump function represents a compensatory mechanism in patients with MS.Thus, these results underline the importance of maintaining a sinus rhythm in these patients.

IntroductionNeutrophil to lymphocyte ratio (NLR) was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied.Aim of the studyTo evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD) in anterior miyocardial infarction patients.Material and methodsPatients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters.ResultsBetween group I (n = 41, mean age 52.5 ±12.7) and group II (n = 17, mean ages 52.0 ±10.8); NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01). In group I, left ventricular ejection fraction (LVEF) was significantly lower (p = 0.02). In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01) and negatively correlated with LVEF (r = –0.28, p = 0.03).ConclusionsThe present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients.