Echocardiographic indices of left ventricular hypertrophy and diastolic function in hypertensive patients with preserved LVEF classified as dippers and non-dippers

Możdżan, Monika; Wierzbowska−Drabik, Karina; Kurpesa, Małgorzata; Trzos, Ewa; Rechciński, Tomasz; Broncel, Marlena; Kasprzak, Jarosław D.

doi:10.5114/aoms.2013.34534

Cited by 22 publications

(17 citation statements)

References 37 publications

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“…In addition to the beta blockers carvedilol, metoprolol CR/XL, and bisoprolol, [ 96 – 99 , 106 ] patients with hypertension, coronary artery disease, and congestive heart failure should be treated with diuretics and ACE inhibitors or angiotensin receptor blockers (ARBs [ 96 – 99 , 106 ], and patients with persistent severe symptoms with aldosterone antagonists [ 96 – 99 , 105 – 107 ]. Hydralazine plus isosorbide dinitrate should be added to African-American patients with New York Heart Association class III or IV heart failure with a reduced left ventricular ejection fraction (HFrEF) already receiving diuretics, beta blockers, and an ACE inhibitor or ARB [ 96 – 99 , 106 , 108 , 109 ]. Drugs to avoid in patients with hypertension and HFrEF include verapamil, diltiazem, doxazosin, clonidine, moxonidine, hydralazine without a nitrate, and nonsteroidal anti-inflammatory drugs [ 96 – 99 ].…”

Section: Antihypertensive Therapymentioning

confidence: 99%

Lipids, blood pressure and kidney update 2015

et al. 2015

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The most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2015 were reviewed. In lipid research, the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial revalidated the concept “lower is better” for low density lipoprotein (LDL)-cholesterol as a target for therapy, increasing the necessity of treatment the high-risk patients to achieve LDL-C goals. After these results, ezetimibe might become the preferred additional drug in the combination therapy of lipid disorders because of oral dosage form and lower acquisition cost. However, for the statin-intolerant patients and those patients requiring essential reductions in LDL-C to achieve their goals, new therapies, including PCSK9 inhibitors remain promising drugs. In blood pressure research, American Heart Association (AHA)/American College of Cardiology (ACC) 2015 guidelines recommended a target for blood pressure below 140/90 mmHg in stable or unstable coronary artery disease patients and below 150/90 mmHg in patients older than 80 years of age, however the recent results of the Systolic Blood Pressure Intervention Trial (SPRINT) trial have suggested that there might be significant benefits, taking into account cardiovascular risk, for hypertensive patients over 50 without diabetes and blood pressure levels <120/80. In kidney research, reducing the progression of chronic kidney disease and related complications such as anemia, metabolic acidosis, bone and mineral diseases, acute kidney injury and cardiovascular disease is still a goal for clinicians.

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Section: Antihypertensive Therapymentioning

confidence: 99%

Lipids, blood pressure and kidney update 2015

et al. 2015

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“…Verdecchia et al [11] studied 137 untreated and 98 healthy hypertensive patients concluded that interventricular thickness and posterior wall thickness were associated with the non-dipper pattern. Możdżan et al compared echocardiographic parameters among hypertensive treated patients with conserved global systolic function concluded that concentric LVH is the prevalent pattern in non-dippers [12]. Ivanovic et al studied hypertensive patients, most of the sample being untreated for hypertension (69%), and concluded that structural alterations were associated with the non-dipper and inverted dipper patterns compared with the other patterns [13].…”

Section: Discussionmentioning

confidence: 99%

The influence of dipper vs. non-dipper pattern on left ventricular function and ascending aorta dimensions in hypertensive patients in Angola

Feijão

Pereira

Cardona

et al. 2019

Arterial Hypertension

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Background. The objective of the present study is to evaluate the effect of the dipper vs. non-dipper patterns on left ventricular function and the dimensions of the ascending aorta in hypertensive patients in Angola. Material and methods. This is a descriptive, observational study performed at the Department of Cardiology of Luanda Medical Center. For this purpose, information on demographic data, echocardiographic parameters and 24-hour-ambulatory blood pressure measurement parameters was collected. All patients underwent both echocardiographic study and 24-hour-ambulatory blood pressure measurement. Dipper pattern is considered when there is a decrease in the nocturnal BP in relation to the daytime BP greater than 10%; if this decrease is not observed either in the systolic blood pressure or in the diastolic blood pressure, the patients are considered non-dippers. Results. We enrolled 159 patients, of which 85 (53.46%) were dippers and 74 (46.54%) were non-dippers, and 87 (54.71%) were male. The mean age (SD) was 43.62 (± 10.73) years. The patients with the non-dipper pattern had larger ascending aortic diameters (29.68 ± 4.88 vs. 27.8 ± 5.18, p = 0.001), higher left ventricular diastolic diameters (52.85 ± 9.24 vs. 50.24 ± 4.16, p = 0.027) and greater posterior wall thickness (10.73 ± 1.94 vs. 10.07 ± 1.70, p = 0.024). In addition, the left ventricular diastolic dysfunction (LVDD) (B = 0.103, p = 0.001) and the posterior wall (PW) thickness (B = 0.350, p = 0.001) are significant estimates of non-dipper pattern. Conclusions. The results show that hypertensive patients with non-dipper pattern have more alterations in left ventricular geometry, but not in left ventricular systolic and diastolic function.

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“…The significant burden of CAD risk factors, such as hypertension and diabetes, and cardiovascular medications may have influenced myocardial function although probably in a homogeneous manner without a predilection to specific regions [32]. We focused on the comparisons of dispersion indices between baseline and the peak stage of DSE and in separate regions of the LV, did not assess the impact of age, sex or regional thickness of the myocardium on variability of strain, and did not analyze the potential relationship of strain heterogeneity with different types of coronary circulation: right or left coronary artery dominance.…”

Section: Discussionmentioning

confidence: 99%

Variability of longitudinal strain in left ventricular segments supplied by non-stenosed coronary artery: insights from speckle tracking analysis of dobutamine stress echocardiograms in patients with high coronary risk profile

Wierzbowska−Drabik¹,

Plewka²,

Kasprzak³

2017

aoms

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IntroductionAlthough global deformation parameters have been increasingly used for myocardial function analysis, there are sparse data concerning segmental deformation of the left ventricle (LV). Moreover, some studies suggest heterogeneity of strain among LV segments, which may be especially significant during stress echocardiography. We assessed quantitatively regional LV function in the setting of dobutamine stress echocardiography (DSE), to examine differences of longitudinal strain between basal, mid and apical LV segments and to compare variability of regional deformation between rest and the peak stage of DSE.Material and methodsAmong 250 patients examined by DSE applied for diagnosis of ischemia, a subset of 111 patients without significant coronary stenoses in angiography was selected (68 females, mean age: 60 ±10 years). Systolic longitudinal strain (SLS) in individual LV segments at baseline and the peak stage of DSE was analyzed with speckle tracking echocardiography.ResultsInhomogeneity of SLS among the LV segments (p < 0.001) was observed at baseline and the peak stage. Dispersion indices were higher at the peak stage of DSE than at baseline (p < 0.001), and the lowest heterogeneity was observed among mid segments. The analysis of changes in SLS during DSE showed SLS reduction in basal and mid-ventricular segments and an increase in apical segments.ConclusionsSignificant heterogeneity of strain and the opposite direction of the longitudinal strain changes during DSE between apical and basal LV segments were observed. This variability among non-ischemic LV segments ought to be considered in quantification of LV function during DSE.

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Echocardiographic indices of left ventricular hypertrophy and diastolic function in hypertensive patients with preserved LVEF classified as dippers and non-dippers

Cited by 22 publications

References 37 publications

Lipids, blood pressure and kidney update 2015

Lipids, blood pressure and kidney update 2015

The influence of dipper vs. non-dipper pattern on left ventricular function and ascending aorta dimensions in hypertensive patients in Angola

Variability of longitudinal strain in left ventricular segments supplied by non-stenosed coronary artery: insights from speckle tracking analysis of dobutamine stress echocardiograms in patients with high coronary risk profile

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