ArticleHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2025
A Practical Predictor for Identifying Reverse-Dipper Blood Pressure Patterns: Left Atrial Coupling Index.
Article in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Ambulatory blood pressure monitoring in arterial hypertension.Internal and emergency medicine · 2026Review
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Abstract
introductionHypertension is a common and persistent disorder and mostly causes myocardial structural and functional abnormalities. As a subtype pattern of HT, the reverse-dipper blood pressure (BP) is associated with worse cardiovascular outcomes and early-phase subclinical myocardial damage compared to other patterns. The Left Atrial Coupling Index (LACI) is a novel echocardiographic parameter developed to assess the mechanical function.
aimThe aim of this study was to investigate the role of the LACI in predicting the reverse-dipper BP pattern in patients with hypertension.
methodsA total of 404 hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring were prospectively enrolled. Patients were classified into dipper, non-dipper, and reverse-dipper groups based on their nocturnal BP profiles. Comprehensive echocardiographic evaluations were performed, and LACI was calculated for each patient.
resultsA reverse-dipper BP pattern was observed in 26%(n = 105) of the 404 patients. Those with a reverse-dipper BP pattern exhibited higher mitral E/A ratio, E/Em means, left atrial volume index (LAVI), and LACI, along with lower Em septal, Am lateral mitral, and Am septal values. LACI (OR:3.837, 95% CI: 2.620-5.620, p < 0.001), LAVI, and Am lateral mitral value were found to be independent predictors of the reverse-dipper BP pattern. ROC curve comparison demonstrated that LACI was a better predictor of the reverse-dipper BP pattern than LAVI.
conclusionsOur study demonstrates that LACI, an easily accessible echocardiographic parameter, is a more robust predictor of the reverse-dipper BP pattern compared to traditional echocardiographic markers.
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