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- Title
Effect of an Increase in Left Ventricular Pressure Overload on Left Atrial-Left Ventricular Coupling in Patients with Hypertension: A Two-Dimensional Speckle Tracking Echocardiographic Study.
- Authors
Miyoshi, Hirokazu; Oishi, Yoshifumi; Mizuguchi, Yukio; Iuchi, Arata; Nagase, Norio; Ara, Nusrat; Oki, Takashi
- Abstract
Background Two-dimensional speckle tracking echocardiography (2 DSTE) has recently been applied to evaluate left atrial ( LA) function in addition to left ventricular ( LV) function. However, whether 2 DSTE can provide insight into LA- LV interaction related to an increase in LV pressure overload remains unknown. Methods One hundred five asymptomatic patients with hypertension were studied by conventional, pulsed and tissue Doppler, and 2 DSTE. Hypertensive patients were classified into 2 groups according to the ratio of early diastolic to atrial systolic velocity (E/A) of transmitral flow: E/A ≥ 1 (n = 37) and E/A < 1 (n = 68). We used (E/peak early diastolic mitral annular motion velocity [e′])/peak systolic LA strain (S- LAs) and E/e′, as parameters of LA stiffness during ventricular systole and LV diastolic stiffness, respectively. Results The peak early diastolic LV longitudinal strain rate, and peak early diastolic LA strain and strain rate were lower in the E/A < 1 group than in the E/A ≥ 1 group. The E/e′/S- LAs and E/e′ were greater in the E/A < 1 group. In the E/A < 1 group, systolic blood pressure ( SBP) correlated with LV wall thickness parameters, A, e′, E/e′, peak early diastolic LV longitudinal strain rate, and E/e′/S- LAs. Multivariate regression analysis indicated that A, E/e′, and E/e′/S- LAs were defined as strong predictors related to SBP. Conclusion In patients with hypertension, an elevation in SBP leads to increased LA stiffness during ventricular systole and LV diastolic stiffness, in association with continued and further advanced LV diastolic dysfunction. 2 DSTE is considered a sensitive tool for detecting abnormal LA- LV coupling related to an increased LV pressure overload.
- Subjects
JAPAN; HYPERTENSION epidemiology; ANALYSIS of variance; DIASTOLE (Cardiac cycle); DOPPLER echocardiography; LEFT heart ventricle; PROBABILITY theory; REGRESSION analysis; DESCRIPTIVE statistics; LEFT heart atrium
- Publication
Echocardiography, 2013, Vol 30, Issue 6, p658
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/echo.12117