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Left ventricular systolic and diastolic dyssynchrony in asymptomatic hypertensive patients

Cited 48 time in Web of Science Cited 52 time in Scopus
Authors
Chang, Sung-A; Kim, Hyung-Kwan; Kim, Dae-Hee; Kim, Yong-Jin; Sohn, Dae-Won; Oh, Byung-Hee; Park, Young-Bae
Issue Date
2009-03-10
Publisher
Elsevier
Citation
J Am Soc Echocardiogr. 2009 Apr;22(4):337-42. Epub 2009 Mar 9.
Keywords
AlgorithmsDiastoleEchocardiography, Doppler/*methodsFemaleHumansHypertension/*complications/*ultrasonographyImage Enhancement/methodsImage Interpretation, Computer-Assisted/*methodsMaleMiddle AgedPattern Recognition, Automated/*methodsReproducibility of ResultsSensitivity and SpecificitySystoleVentricular Dysfunction, Left/*etiology/*ultrasonography
Abstract
BACKGROUND: Diastolic and systolic dyssynchrony are common in patients with heart failure. However, the presence of dyssynchrony in asymptomatic patients with hypertension who are susceptible to the development of heart failure is not well understood. The aims of this study were (1) to evaluate the prevalence of systolic and diastolic dyssynchrony and (2) to identify the main determinants of left ventricular (LV) dyssynchrony in asymptomatic patients with hypertension. METHODS: One hundred ten patients with hypertension consecutively enrolled were compared with 55 age-matched and gender-matched normal control subjects. Comprehensive echocardiography was performed, including conventional and Doppler tissue imaging parameters. LV end-systolic wall stress was calculated using a hemodynamic and echocardiographic M-mode data set. For the assessment of LV dyssynchrony, both the standard deviation of the time from QRS onset to peak systolic velocity and the maximal difference of the time from QRS onset to peak systolic velocity from 6 basal segments at the apical views were used and were compared between the two groups. RESULTS: Both systolic and diastolic dyssynchrony indexes were significantly higher in patients with hypertension than in the normal controls (P < .001), with no significant correlation between the systolic and diastolic dyssynchrony indexes. The proportions of patients with hypertension who had LV systolic and diastolic dyssynchrony were 24% and 21%, respectively. Multivariate analysis showed that the E/E' ratio (P < .001) was independently associated with LV systolic dyssynchrony, whereas LV mass index (P = .001) and E/E' (P < .001) were major determinants of LV diastolic dyssynchrony. CONCLUSIONS: LV systolic and diastolic dyssynchrony are not uncommon in asymptomatic patients with hypertension and are significantly associated with LV filling pressure. The determinants of LV systolic dyssynchrony are not the same as those of diastolic dyssynchrony, implying that different mechanisms are involved in the development of LV systolic and diastolic dyssynchrony in asymptomatic patients with hypertension.
ISSN
1097-6795 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19269134

http://www.mdconsult.com/das/article/body/176309319-2/jorg=journal%26source=%26sp=21988746%26sid=0/N/693043/s0894731709001011.pdf?issn=08947317

http://hdl.handle.net/10371/62325
DOI
https://doi.org/10.1016/j.echo.2009.01.024
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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