A Practical Predictor for Identifying Reverse-Dipper Blood Pressure Patterns: Left Atrial Coupling Index

Area of Science:

• Cardiology
• Hypertension Research
• Echocardiography

Background:

• Hypertension frequently causes myocardial abnormalities.
• The reverse-dipper blood pressure (BP) pattern is linked to adverse cardiovascular outcomes and subclinical heart damage.
• The Left Atrial Coupling Index (LACI) is a new echocardiographic tool for assessing cardiac function.

Purpose of the Study:

• To evaluate the Left Atrial Coupling Index (LACI) as a predictor for the reverse-dipper BP pattern in hypertensive individuals.

Main Methods:

• 404 hypertensive patients were enrolled, undergoing 24-hour ambulatory BP monitoring.
• Patients were categorized into dipper, non-dipper, and reverse-dipper groups based on nocturnal BP.
• Echocardiography was performed, and LACI was calculated for all participants.

Main Results:

• The reverse-dipper BP pattern was identified in 26% of patients.
• Reverse-dipper patients showed higher LACI, mitral E/A, E/Em, and left atrial volume index (LAVI).
• LACI, LAVI, and Am lateral mitral value independently predicted the reverse-dipper pattern; LACI outperformed LAVI.

Conclusions:

• The easily measured LACI is a superior echocardiographic predictor of the reverse-dipper BP pattern.
• LACI offers a more robust assessment compared to conventional echocardiographic markers for this hypertension subtype.