The online version of this article (doi:10.1186/1476-7120-10-46) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests
ID, PP, and LD planned the study, investigated all patients, performed measurements and analyzed the data. ID and LD performed statistical analysis and wrote the manuscript. ID and PP made critical review of the paper. All authors read and approved the final manuscript.
The aim of this study was to investigate early changes in left ventricular longitudinal systolic function in patients with hypertension (HTN) with and without concomitant diastolic dysfunction (DD) and the clinical implications of these findings.
We enrolled 299 patients with HTN and 297 age-matched patients with HTN and DD and compared both groups with an age-matched control group consisting of 100 healthy subjects. The long axis systolic function was investigated by determining the average peak systolic velocity of the septal and lateral mitral sites (Smavg) using spectral pulsed wave tissue Doppler imaging (TDI).
We found a strong negative trend toward the reduction of velocity, which is dependent on the grade of HTN, on the magnitude of DD, and also on the gender and age of the subjects (r=−0.891/-0.580; p<0.0001). The data showed that the beginning and evolution of HTN are related to a slight but significant reduction in the long axis systolic function (10.2-10.0 cm/s; p<0.0001), and DD worsens this initial finding (9.8-8.8 cm/s; p<0.0001).
The strength of the study is the analysis of incremental changes in longitudinal contraction in patients with different stage of HTN but not so many the classification of the degree of systolic dysfunction. The importance of our results lies in the fact that these initial changes in systolic contraction could be used as an early sign that should prompt optimization of the treatment of HTN.
Antezana FS: Epidemiologic aspects of hypertension in the world. First International Symposium Hypertension. One Medicine, Two Cultures Compared Medicine, 1996.
Mancia G, Backer G, Dominiczak A, Cifkova R, et al.: The task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC). Eur Heart J. 2007, 28: 1462-1536. PubMed
Galderisi M, Caso P, Dandrea A, et al.: Pulsed tissue Doppler distinguishes physiologic by hypertensive determined left ventricular hypertrophy. Eur Heart J. 2000, 21 (abstr. supl): 485-
Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM, et al.: Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the japanese society of echocardiography. J Am Soc Echocardiogr. 2011, 24: 277-313. 10.1016/j.echo.2011.01.015 CrossRefPubMed
Gottdiener J, Bednarz J, Devereux R, Gardin J, Klein A, Manning W, Morehead A, Kitzman D, Oh J, Quinones M, Schiller N, Stein J, Weissman NJ: American society of echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr. 2004 Oct, 17 (10): 1086-1119. PubMed
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ: Recommendations for chamber quantification: a report from the American society of echocardiography’s guidelines and standards committee and the chamber quantification writing group. J Am Soc Echocardiogr. 2005, 18: 1440-1463. 10.1016/j.echo.2005.10.005 CrossRefPubMed
Madler CF, Pyne N, Derumeaux G, et al.: Aging of left ventricular diastolic function affects the subendocardium and first involves the septum. Eur Heart J. 2003, 24 (Abstr supl): 401- CrossRef
Onose Y, Oki T, Mishiro Y, et al.: Influence of aging on systolic left ventricular wall motion velocities along the long and short axes in clinically normal patients determined by tissue pulsed Doppler imaging. J Am Soc Echocardiograph. 1999, 12: 921-926. 10.1016/S0894-7317(99)70144-6. CrossRef
Nikitin NP, Witte KK, Thackray SD, et al.: Longitudinal ventricular function: normal values of atrioventricular annular and myocardial velocities measured with quantitative two-dimensional color Doppler tissue imaging. J Am Soc Echocardiogr. 2003, 16: 906-921. 10.1016/S0894-7317(03)00279-7 CrossRefPubMed
Inneli P, Sanchez R, Marra F, et al.: The impact of aging on left ventricular longitudinal function in healthy subjects: a pulsed tissue Doppler study. Eur J Echocardiogr. 2008, 9: 241-249.
- Mitral annular systolic velocity as a marker of preclinical systolic dysfunction among patients with arterial hypertension
Ivaylo Rilkov Daskalov
Plamen Dimitrov Petrovsky
Lilia Davidkova Demirevska
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II