|
KMID : 0648320030090010049
|
|
Journal of The Korean Society of Hypertension
2003 Volume.9 No. 1 p.49 ~ p.56
|
|
|
The Relation of Circadian Blood Pressure Variation to Left Ventricular Mass, Diastolic Function and QT interval
|
|
Kim Soo-Joong
Lee Byung-Ho
Sohn Il-Suk
Kang Heung-Sun
Cho Chung-Whee
Kim Kwon-Sam
Song Jung-Sang
Bae Jong-Hwa
|
|
|
Abstract
|
|
|
Background: The clinical significance of the extent of fall in nocturnal blood pressure (BP) and the resulting
classification of hypertensives as dipper (fall in nocturnal BP > 10% of daytime BP) or non-dipper (fall in nocturnal
BP < 10% of daytime BP) has been questioned recently. So the aim of our study was to demonstrate if the extent
of nocturnal BP fall is related to left ventricular (LV) mass, LV diastolic index and QT interval.
Methods: We enrolled 81 subjects receiving the examinations of 24-hour ambulatory BP monitoring (24hr ABPM),
2-dimensional echocardiography with Doppler and electrocardiography (ECG). On the basis of 24hr ABPM results,
we classified the subjects into normotensive group, dipper group and non-dipper group. With echocardiography,
we measured LV mass (LVM) and LV diastolic indices (E/A ratio, deceleration time, isovolumic relaxation time)
using Doppler of transmitral inflow. QT and QTc intervals were automatically computed from standard 12-lead
ECG.
Results: Of 81 patients, 23 patients belonged to dipper group and 21 patients to non-dipper group. Three groups
did not differ with regard to clinical characteristics. In 24hr ABPM results, there was difference in 24hr average
heart rate (HR), daytime HR and daytime systolic BP between dipper and non-dipper group. Non-dipper group
had greater LVM index (LVMI) than dipper group (141.2±37.9 vs 105.1±29.7g/m2, p<0.001). Also non-dipper
group had lower E/A ratio (1.0±0.4 vs 1.39±0.3, p<0.005) and more prolonged DT (251.9±37.9 vs 211.9±21.9ms,
p<0.001) and IVRT (104.7±21.2 vs 85.7±10.1ms, p<0.001) than dipper group. QTc interval was significantly
prolonged in non-dipper group than in dipper group (437.0±22.4 vs 415.2±18.9ms, p<0.05).
Conclusions: Non-dipper group of hypertensive patients had a greater LVMI, more impaired diastolic function and more prolonged QTc interval than dipper group, suggesting the possibility of much more chance of cardiovascular
events and their complications in non-dipper group than dipper group.
|
|
|
KEYWORD
|
|
|
Hypertension, Dipper, Non-dipper, Left ventricular mass
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|