Diurnal blood pressure pattern in pateinte with iscemic and dilate cardiyomyopaty

AİM: Heart failure is a cronic progression caracterized with noroendocrine system maladaptation. In this cronic progressive situation there is an increasing in sympatic activity and periferic vascular rezistance and a decreasing in baroreseptor sensitivity. This could be the cause of changing diurnal ritm of blood pressure. However some trials show circadian ritm of blood pressure in the patiens with severe systolic heart failure are not different from control groups but generally trials show nondipper and reverse dipper patients with severe heart failure are more often than the others. There is no trial about effects of heart failure etiology on this situation. Our purpose is searching circadian ritm between iscemic and noniscemic cardiyomyopaty patientsMATERİAL AND METHOD: İn our study we use 66 patients, 22 iscemic cardiyomyopaty, 22 with noniscemic cardiyompaty and 22 as control goup. Whose ejection fraction is under %40 wity sinus ritm, left heart enlargement, no biventricular pace implantation, no severe heart valve disease and who is not receiving dializ. Hemogram and routine laboratory tests of all paitents were studied, BMI and GFR were calculated. Echocardiografic test of all patients were made and each patient took a 24 hour ambulatory blood pressure device and prepared for the study.FİNDİNGS: İn the iscemic cardiyomyopaty group (21M,1F) men women there were satistically significant high man patient ratio than dilate cardiyomyopaty group (14M,8F) and control group (13M, 9F). Besides there was statistically high statin use in iscemic cardiyomyopaty group than noniscemic cardiyomyopaty group. There were no differences between iscemic cardiyomyopaty and noniscemic cardiyomyopaty patients for ejection fraction, age, DM, HT, GFR, BMI, hemogram and routine laboratory tests. İn control group dippers, in noniscemic cardiyomyopaty group nondippers and in iscemic cardiyomyopaty group reverse dippers were statistically significant high. Among these groups p <0,001 .CONCLUİSİON: Diurnal ritm of blood pressure in severe systolic heart failure is changing in our sudy. İn dilate cardiyomyopaty group %54 of patients were nondipper, %27,3 of patients were reverse dipper, İn iscemic cardiyomyopaty group %63,6 of patients were reverse dipper and %27,3 of patients were nondipper. When we combine the findings of our study in iscemic cardiyomyopaty group mortality and hospitalization in the future was higher than noniscemic cardiyomyopaty group because reserve dippers were significantly high in this group However we know the importance of ambulatory blood pressure monitorization and nondipper situation in prognosis of congestif heart failure in these patients Ambulatory blood pressure monitorization has an important role for determining drug taking hours.