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Updated: Aug 29, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
The influence of ambulatory blood pressure profile on left ventricular geometry
Bahattin Balci1, Ozcan Yilmaz, Osman Yesildag
1Department of Cardiology, Ondokuz Mayis University, 55060 Samsun, Turkey. bahattinbalci@ttnet.net.tr
Insights
Hypertension can alter left ventricular geometry. Patients with hypertension whose blood pressure does not sufficiently decrease at night (nondipper) are more likely to develop eccentric hypertrophy.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiac Imaging
Background:
- Hypertension is known to cause left ventricular hypertrophy and geometric changes.
- Elevated blood pressure, particularly insufficient nocturnal dipping, may contribute to adverse cardiac remodeling.
- Understanding the impact of 24-hour blood pressure patterns on left ventricular structure is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate the relationship between 24-hour ambulatory blood pressure profiles and left ventricular geometry in untreated patients with mild to moderate hypertension.
- To determine if nocturnal blood pressure dipping status influences the prevalence of different left ventricular geometric patterns.
Main Methods:
- Sixty patients with mild to moderate, untreated hypertension underwent 24-hour ambulatory blood pressure monitoring.
- Echocardiographic evaluation was performed to assess left ventricular mass index and relative wall thickness.
- Patients were categorized into dipper (nighttime BP decrease >10%) and nondipper groups based on their BP profiles.
Main Results:
- No significant differences in age, gender, or baseline blood pressure were observed between dipper and nondipper groups.
- Prevalence of normal geometry, concentric remodeling, and concentric hypertrophy were similar in both groups.
- Eccentric hypertrophy was significantly more prevalent in the nondipper group (42.9%) compared to the dipper group (6.3%, P < 0.03).
Conclusions:
- Inadequate nocturnal blood pressure reduction in hypertensive individuals is associated with a higher incidence of eccentric hypertrophy.
- These findings highlight the importance of 24-hour blood pressure monitoring in identifying patients at risk for specific left ventricular remodeling patterns.
- Targeting nocturnal blood pressure control may be beneficial in preventing adverse cardiac structural changes in hypertension.
Abstract:
Besides causing a hypertrophy in the left ventricle, hypertension results in a change in the geometry of the left ventricle. The blood pressure, which does not decrease enough during the night, leads to structural changes in the left ventricle. In this study, the influence of 24-hour blood pressure profile on the left ventricular geometry was examined. Ambulatory blood pressure monitoring was applied to 60 patients with mild to moderate hypertension who had never been treated and standard echocardiographic evaluation was conducted thereafter. The patients were divided into two groups with respect to the ambulatory blood pressure profiles: the patients whose night blood pressure levels decreased by more than 10% compared to their daytime blood pressure levels (dipper) and those whose levels did not decrease that much (nondipper). The left ventricle mass index and the relative wall thickness of the patients were calculated. With respect to the left ventricle geometry, mass index and relative wall thickness of the patients were determined as: having normal geometry, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. Age, gender, systolic, and diastolic blood pressure were similar within the dipper and nondipper groups. Normal geometry, concentric remodeling, and concentric hypertrophy ratios were similar in both groups. Eccentric hypertrophy was higher in the nondipper group compared to the dipper group (42.9% vs 6.3%, P < 0.03). Patients with mild to moderate hypertension, whose blood pressure does not decrease enough, develop eccentric hypertrophy.
