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12.02.2019 | Original Investigation | Ausgabe 4/2019

Journal of Echocardiography 4/2019

Noninvasive assessment of left-ventricular diastolic electromechanical coupling in hypertensive heart disease

Zeitschrift:
Journal of Echocardiography > Ausgabe 4/2019
Autoren:
Yuko Saito, Hirotsugu Yamada, Kenya Kusunose, Ken Saito, Masataka Sata
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s12574-019-00421-4) contains supplementary material, which is available to authorized users.

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Abstract

Background

There is a need to stratify patients who may develop heart failure because of the current “heart failure pandemic”. We hypothesized that noninvasive assessment of diastolic electromechanical coupling by electrocardiography and Doppler echocardiography may be clinically useful for risk stratification of hypertensive patients who may develop heart failure.

Methods

We measured the time from the peak to end of the T wave (TpTe) as an electrophysiological parameter, and peak early diastolic mitral flow (E) and lateral annular (e′) velocities as mechanical parameters in 109 patients with hypertension. Relationships between these parameters and their association with the prognosis were evaluated.

Results

The e′ was inversely correlated with TpTe (p < 0.001) and QTc (p < 0.014), whereas E/e′ was positively correlated with TpTe (p < 0.001) and QTc (p < 0.001). The TpTe predicted patients with E/e′ > 12. There were 24 cardiovascular events during follow-up (57 ± 20 months), and Kaplan–Meier analysis showed that outcome was worse (p = 0.003) in patients with higher E/e′ than lower E/e′; however, there was no difference between patients with longer TpTe (≧72 ms) and shorter TpTe (< 72 ms).

Conclusion

The correlation of TpTe with e′ and E/e′ in hypertensive patients suggests that these parameters reflect diastolic ventricular electromechanical coupling. The E/e′ predicted outcome, and an elevated E/e′ should be suspected when TpTe is prolonged (> 72 ms). Noninvasive evaluation of diastolic electromechanical coupling is clinically useful in patients with hypertension for predicting their outcome.

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