PMID- 23840777 OWN - NLM STAT- MEDLINE DCOM- 20171010 LR - 20211021 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 8 IP - 6 DP - 2013 TI - Nocturnal Blood Pressure Pattern Affects Left Ventricular Remodeling and Late Gadolinium Enhancement in Patients with Hypertension and Left Ventricular Hypertrophy. PG - e67825 LID - 10.1371/journal.pone.0067825 [doi] LID - e67825 AB - BACKGROUND: Left ventricular hypertrophy (LVH) is an independent predictor of cardiac mortality, regardless of its etiology. Previous studies have shown that high nocturnal blood pressure (BP) affects LV geometry in hypertensive patients. It has been suggested that continuous pressure overload affects the development of LVH, but it is unknown whether persistent pressure influences myocardial fibrosis or whether the etiology of LVH is associated with myocardial fibrosis. Comprehensive cardiac magnetic resonance (CMR) including the late gadolinium enhancement (LGE) technique can evaluate both the severity of changes in LV geometry and myocardial fibrosis. We tested the hypothesis that the nocturnal non-dipper BP pattern causes LV remodeling and fibrosis in patients with hypertension and LVH. METHODS: Forty-seven hypertensive patients with LVH evaluated by echocardiography (29 men, age 73.0+/-10.4 years) were examined by comprehensive CMR and 24-h ambulatory blood pressure monitoring (ABPM). RESULTS AND CONCLUSIONS: Among the 47 patients, twenty-four had nocturnal non-dipper BP patterns. Patients with nocturnal non-dipper BP patterns had larger LV masses and scar volumes independent of etiologies than those in patients with dipper BP patterns (p = 0.035 and p = 0.015, respectively). There was no significant difference in mean 24-h systolic BP between patients with and without nocturnal dipper BP patterns (p = 0.367). Among hypertensive patients with LVH, the nocturnal non-dipper blood pressure pattern is associated with both LV remodeling and myocardial fibrosis independent of LVH etiology. FAU - Yokota, Hajime AU - Yokota H AD - Department of Cardiology, Tokyo Metropolitan Geriatric Hospital, Itabashi, Tokyo, Japan. FAU - Imai, Yasuko AU - Imai Y FAU - Tsuboko, Yusuke AU - Tsuboko Y FAU - Tokumaru, Aya M AU - Tokumaru AM FAU - Fujimoto, Hajime AU - Fujimoto H FAU - Harada, Kazumasa AU - Harada K LA - eng PT - Journal Article DEP - 20130626 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Aged MH - Blood Pressure/*physiology MH - Blood Pressure Monitoring, Ambulatory MH - Circadian Rhythm/*physiology MH - Echocardiography MH - Female MH - Gadolinium/*metabolism MH - Humans MH - Hypertension/*physiopathology MH - Hypertrophy, Left Ventricular/*physiopathology MH - Image Enhancement MH - Magnetic Resonance Imaging MH - Male MH - Prospective Studies MH - Ventricular Remodeling/*physiology PMC - PMC3694091 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2013/07/11 06:00 MHDA- 2013/07/11 06:01 PMCR- 2013/06/26 CRDT- 2013/07/11 06:00 PHST- 2013/01/24 00:00 [received] PHST- 2013/05/21 00:00 [accepted] PHST- 2013/07/11 06:00 [entrez] PHST- 2013/07/11 06:00 [pubmed] PHST- 2013/07/11 06:01 [medline] PHST- 2013/06/26 00:00 [pmc-release] AID - PONE-D-13-03709 [pii] AID - 10.1371/journal.pone.0067825 [doi] PST - epublish SO - PLoS One. 2013 Jun 26;8(6):e67825. doi: 10.1371/journal.pone.0067825. Print 2013.