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Erschienen in:
12.02.2019 | Original Investigation
Noninvasive assessment of left-ventricular diastolic electromechanical coupling in hypertensive heart disease
Erschienen in: Journal of Echocardiography | Ausgabe 4/2019
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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.