The relationship between presystolic wave and nondipper hypertension


Kahyaoglu M., Bayam E., Gunay N., Gecmen C., Candan Ö., Yilmaz Y., ...More

Blood Pressure Monitoring, vol.25, no.3, pp.142-146, 2020 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 3
  • Publication Date: 2020
  • Doi Number: 10.1097/mbp.0000000000000432
  • Journal Name: Blood Pressure Monitoring
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.142-146
  • Keywords: diastolic dysfunction, nondipper hypertension, presystolic wave
  • Uşak University Affiliated: No

Abstract

Background A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), and the possible mechanism for PSW is considered to be left ventricular stiffness and impaired LV compliance. We aimed to compare the relationship between PSW and dipper, nondipper hypertension. Patients and methods A total of 83 patients were included in the study. The participating patients were divided into two groups as 42 patients with dipper hypertension and 41 patients with nondipper hypertension based on the results of ambulatory blood pressure monitoring. Results Left ventricular mass index (91.6±12.9 vs. 106.1±7.9, P<0.001) and E/Em (7.4 [6.6–8.3] vs. 10 [8–12], P<0.001) were significantly higher, and Em (9.9±2.7 vs. 7.9±3.4, P=0.004) was significantly lower in the nondipper group compared with dipper group. And also, the PSW was found to be higher in the nondipper group. The nondipper group had markedly increased frequencies of PSW compared with the dipper group (68 vs. 38%, respectively, P=0.008). In the multivariate logistic regression test, E/Em [odds ratio (OR) 1.464, 95% confidence interval (CI): 1.113–1.926, P=0.006] and the presence of PSW (OR 3.115, 95% CI: 1.061–9.143, P=0.039) were determined as independent predictive parameters for nondipper hypertension. Conclusion The presence of PSW on transthoracic echocardiography suggests that we may come across nondipper hypertension and a high risk of end-organ damage. PSW may be used as a useful parameter in risk stratification in hypertensive patients.