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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.
MedLine Citation:
PMID:  23347200     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Two-dimensional speckle tracking echocardiography (2DSTE) has recently been applied to evaluate left atrial (LA) function in addition to left ventricular (LV) function. However, whether 2DSTE 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 2DSTE. 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. 2DSTE is considered a sensitive tool for detecting abnormal LA-LV coupling related to an increased LV pressure overload.
Authors:
Hirokazu Miyoshi; Yoshifumi Oishi; Yukio Mizuguchi; Arata Iuchi; Norio Nagase; Nusrat Ara; Takashi Oki
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-24
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  -     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013, Wiley Periodicals, Inc.
Affiliation:
Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, Tokushima, Japan.
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