14 In the posterior orbital, cortex, and ventrolateral PFC, volume has also been shown to be reduced in in vivo volumetric MRI studies15,16 and in postmortem neuropathological studies of MDD.17,18 Reductions in gray matter volume were also found in the dorsomedial/dorsal anterolateral PFC in M’DD subjects versus controls,19 and postmortem studies of MDD and BD reported EX 527 manufacturer abnormal reductions in the size of neurons and/or the density of glia.18,20,21 Temporal lobe structures Morphometric MRI studies of specific temporal lobe structures

reported significant, reductions in the hippocampal volume in MDD, with magnitudes of difference Inhibitors,research,lifescience,medical ranging from 8% to 19% with Inhibitors,research,lifescience,medical respect to healthy controls.22,28

Sheline et al23 and MacOueen et al28 reported that the hippocampal volume was negatively correlated with the total time spent, depressed or with the number of depressive episodes in MDD. Other groups found no significant differences between MDD and control samples.29-35 The inconsistency in the results of MDD studies may reflect pathophysiological heterogeneity within the MDD samples studied. For example, Vythilingam et al36 reported that the hippocampal volume was abnormally decreased in depressed women who also had suffered Inhibitors,research,lifescience,medical early-life trauma, but not in women who had depression without early-life trauma. In

BD, reductions in hippocampal volume were identified by Noga et al37 and Swayze Inhibitors,research,lifescience,medical et al38 relative to healthy controls, although Pearlson et al39 and Nugent et al27 found no differences between BD and control samples. In postmortem studies of BD, abnormal reductions in the mRNA concentrations of synaptic proteins40 and in apical dendritic spines of pyramidal cells41 were specifically observed in the subicular and ventral CA1 subregions of the hippocampus. A recent study using high-resolution MRI Inhibitors,research,lifescience,medical scans found that the volume of the subiculum, but not the remainder of the hippocampus, was decreased out in BD relative to control samples.27 Two studies reported abnormalities of the hippocampal T1 MRI signal in MDD. Krishnan et al42 observed that the T1 relaxation time was reduced in the hippocampus, but not in the entire temporal lobe, in unipolar depressives relative to healthy controls, and Sheline et al23 observed that elderly subjects with MDD have a higher number of areas with a low MRI signal than age-matched controls in T1-weighted images. The significance of such abnormalities remains unclear. In the amygdala, the literature is in disagreement. Studies of MDD have reported that amygdala volume is decreased,43,44 increased,45 or not different26 in depressives relative to healthy controls.

Fig 2 Bland-Altman analyses for intra- and inter-observer variab

Fig. 2 Bland-Altman analyses for intra- and inter-observer variability. Discussion In this study, we demonstrated that patients in the nevertreated non-dippers group had exaggerated

Selleck BI6727 reservoir and booster pump functions of the LA. Many volumetric parameters of the LA showed differences between the dipper and nondipper groups. Thus, the LA maximal volume index, LA volume at the onset of the atrial systole, LA expansion index, Inhibitors,research,lifescience,medical LA active emptying volume, LA active emptying fraction and the LA ejection fraction were all significantly increased in the nondippers group. These findings were consistent with results from a previous study performed by Aydin et al.16) In addition, in this study, Inhibitors,research,lifescience,medical we evaluated the LA function using the tissue Doppler and strain imaging methods which were relatively newly introduced. Although there were no differences between the two investigated groups in tissue velocities, both strain and strain rate of the LA showed significant differences between dippers and non-dippers. Thus, the peak LA strain Inhibitors,research,lifescience,medical measured during the reservoir period was significantly increased in the non-dippers group. The peak LA strain rates evaluated during both reservoir and contractile periods were also increased in the non-dipper patients. In contrast, the deformation parameters of the LA were not correlated with the serum levels of natriuretic peptides (i.e. NT-proBNP

and ANP), demonstrating cardiac muscle stretching. In hypertensive patients, LV hypertrophy occurs and results in diastolic dysfunction. Systemic hypertension is the leading cause of left ventricular Inhibitors,research,lifescience,medical hypertrophy and impaired left ventricular diastolic filling. Enlargement of the left atrium might be attributed to the Inhibitors,research,lifescience,medical impairment of blood flow from left atrium to left ventricle due to increased left ventricular stiffness.20) The LA functions as a reservoir, passive conduit and booster pump, according to various cardiac cycles, and acts as a modulator of the diastolic function of the LV.10) LA reservoir functions occur during the ventricular systole and the passive conduit functions occur in the early diastole. The reservoir

function of the LA is affected when there is acute LV regional ischemia Phosphoprotein phosphatase and it is determined by the systolic function of the LV, as well as the relaxation period of the LA.20) The LA also acts as an active contractile chamber that augments the filling of the left ventricle during the late diastole, and as a suction source that refills itself in the early systole.20) The active atrial emptying increases to maintain sufficient output in case of systemic hypertension, where LV diastolic function deteriorates.21) In our study non-dipper patients showed significantly increased LA strain rate during the late diastole, representing booster pump function of the LA. The function of the LA in hypertensive patients is different from the normal subjects.