Comparison of atrial electromechanical coupling interval and P-wave dispersion in non-dipper versus dipper hypertensive subjects

• Published in: Blood pressure Vol. 20; no. 1; pp. 60 - 66
• Main Authors: Ermis, Necip, Acikgoz, Nusret, Cuglan, Bilal, Cansel, Mehmet, Yagmur, Julide, Tasolar, Hakan, Barutcu, Irfan, Pekdemir, Hasan, Ozdemir, Ramazan
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.02.2011; Taylor & Francis
• Subjects: Atrial Function; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Echocardiography, Doppler, Color; Electrophysiologic Techniques, Cardiac; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart Conduction System - diagnostic imaging; Heart Conduction System - physiopathology; Humans; Hypertension - diagnostic imaging; Hypertension - physiopathology; Inter-atrial electromechanical coupling intervals; Male; Middle Aged; non-dipper hypertension; P-wave dispersion
• ISSN: 0803-7051; 1651-1999; 1651-1999
• DOI: 10.3109/08037051.2010.532302

Abstract Background. The lack of nocturnal BP fall less than 10% of the daytime, called non-dipper hypertension, is associated with increased cardiovascular morbidity and mortality. The aim of our study was to investigate atrial conduction time in patients with non-dipper hypertension using electromechanical coupling interval and P-wave dispersion (PWD), measured with the surface electrocardiogram and tissue Doppler echocardiographic imaging (TDI). Methods. Age- and sex-matched 43 dipper hypertensive patients (19 male, 24 female, mean age: 53.9 ± 10.5 years), 40 non-dipper patients (18 male, 22 female, mean age 54.3 ± 9.6 years) and 46 healthy subjects (22 male, 24 female, mean age: 52.8 ± 9.6 years) were included in the study. The difference between the maximum and minimum P-wave durations was calculated and defined as PWD. Atrial electromechanical coupling (PA), inter-atrial and intra-atrial electromechanical delays were measured with TDI. Results. PWD was significantly higher in patients with non-dippers compared with dippers (p <0.02) and controls (p <0.001). The inter-atrial conduction time was delayed in non-dippers compared with dippers (p <0.01) and controls (p <0.001). There was a positive correlation between left atrial (LA) diameter and inter-atrial conduction times (r = 0.46, p <0.001). LA diameter was also correlated with PWD (r = 0.44, p <0.001). Conclusion. The patients with non-dipper hypertension have higher P-wave duration, PWD and delayed inter-atrial electromechanical coupling intervals compared with those of dippers and controls. This indicates that these subjects may be more prone to atrial rhythm disturbances.