Non-dipper hipertansiyon ile presistolik dalga ve sol atriyum fonksiyonları arasındaki ilişki

Amaç: Bu çalışmanın amacı presistolik dalga (PSD) varlığı ve non-dipper hipertansiyon arasındaki ilişkiyi araştırmaktır. Ayrıca PSD oluşumuna sol atriyum fonksiyonlarındaki değişimin etkisi olup olmadığı araştırılması amaçlanmıştır. Gereç ve Yöntem: Bu kesitsel çalışmaya 77 dipper ve 43 non-dipper hipertansiyonu olan 120 hasta dahil edildi. Dipper ve non-dipper hipertansiyon grupları, PSD varlığı ve sol atriyum fonksiyon ekokardiyografik parametreleri açısından birbirleriyle karşılaştırıldı. Bulgular: Sol atriyum aktif boşalma fraksiyonu (SAABF) (38.6 ± 2.8’ e karşı 35.1 ± 3.3) ve PSD insidansı (%69.8’ e karşı %37.7) non-dipper hipertansiyon grubunda dipper hipertansiyon grubuna göre anlamlı olarak daha yüksekti. Yaş, miyokardiyal pik erken diyastolik hız (Em), sol atriyum minimum hacmi, SAABF (odds oranı = 1.719, 95% güven aralığı = 1.367–2.162) ve PSD (odds oranı = 7.116, 95% güven aralığı = 2.063–24.548) non-dipper hipertansiyonun bağımsız öngördürücüleri olarak bulundu. Presistolik dalgası olan ve olmayanlar içinde non-dipper hipertansiyon ve dipper hipertansiyonu olan gruplar SAABF’ sine göre karşılaştırıldığında non-dipper hipertansiyon grubunda SAABF anlamlı olarak daha yüksek izlendi. Sonuç: PSD'nin varlığı hipertansiyonu hastalarında daha yüksek riskli olan non-dipper grubun kolayca saptanmasında fayda sağlayabilir. Bu hasta grubunda PSD' nin daha sıklıkla oluşumu diyastolik dolumu korumak için artmış sol atriyum kasılmasından bağımsızdır.

Anahtar Kelimeler:

ekokardiyografi, hipertansiyon, sol atriyum fonksiyonları, sol ventrikül fonksiyonları

Relationship between non-dipper hypertension with presystolic wave and left atrial functions

Purpose: This study aims to investigate the relationship between presystolic wave (PSW) and non-dipper hypertension. In addition, it was aimed to investigate whether the change in left atrial functions affects PSW. Materials and Methods: 120 patients with 77 dipper hypertension and 43 non-dipper hypertension were included in this cross-sectional study. Dipper and non-dipper hypertension groups were compared with each other in terms of PSW presence and echocardiographic parameters of the left atrial function. Results: Left atrial active emptying fraction (LAAEF) (38.6 ± 2.8 vs. 35.1 ± 3.3) and PSW incidence (69.8% vs. 37.7%) were significantly higher in the non-dipper hypertension group than in the dipper hypertension group. Age, myocardial peak early diastolic velocity (Em), left atrial minimum volume, LAAEF (odds oranı = 1.719, 95% Confidence Interval = 1.367–2.162) and PSW (odds oranı = 7.116, 95% Confidence Interval = 2.063–24.548) were found to be independent predictors of non-dipper hypertension. When the groups with non-dipper hypertension and dipper hypertension were compared with and without presystolic waves, LAAEF was found to be significantly higher in the non-dipper hypertension group. Conclusion: The presence of PSW may be beneficial in easily detecting the non-dipper group, which has a higher risk in hypertension patients. The more frequent occurrence of PSW in this patient group is independent of increased left atrial contraction to maintain diastolic filling

Keywords:

echocardiography, hypertension, left atrial function, left ventricular function,

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