Electro-mechanical atrial and diastolic dysfunction in hypertensive patterns

Objectives: Diastolic dysfunction (DD) remains a diagnostic challenge, particularly in hypertensive patients with non-dipping blood pressure profiles.Emerging evidence suggests that left atrial reservoir strain (LASr) and P-wave dispersion (Pd) may serve as sensitive, non-invasive markers for subclinical atrial dysfunction.Patients and methods: This single-center, retrospective observational study included 176 individuals: 76 non-dipper hypertensive, 65 dipper hypertensive, and 35 normotensive controls.All subjects underwent transthoracic echocardiography and 12-lead electrocardiogram (ECG).LASr was measured via speckle-tracking echocardiography, and Pd was manually calculated from standard ECGs.Results: Non-dipper patients exhibited significantly reduced LASr (19.27±5.1%)and increased Pd (50.57±8.1 ms) compared to dippers and controls (p