Özden SEÇKİN, Mustafa CANDEMİR, Serkan ÜNLÜ
Cardiovascular Surgery and Interventions - 2026;13(1):31-35
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<0.001). A strong inverse correlation between LASr and Pd was observed. DD prevalence was highest among non-dippers (92.0%). Receiver operating characteristic analysis identified a Pd cut-off of 40.5 ms with 83% sensitivity, 80% specificity, and area under the curve 0.84 (95% confidence interval: 0.78-0.90) for detecting DD. Conclusion: LASr and Pd provide complementary insights into atrial mechanical and electrical remodeling in hypertensive patients. Pd, as a simple and cost-effective ECG marker, may serve as a valuable tool for identifying DD, especially when advanced imaging is unavailable. These findings support integrating Pd into routine hypertensive patient evaluation.
