Doppler Tissue Echocardiography: Myocardial Wall Motion Velocities in Essential Hypertension

Pelà, Giovanna; Bruschi, G; Cavatorta, A; Manca, C; Cabassi, Aderville; Borghetti, A

doi:10.1053/euje.2000.0057

Cited by 41 publications

(33 citation statements)

References 17 publications

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“…[11][12][13][14] Asymmetry in LV longitudinal and circumferential systolic function in hypertensive patients with the former being more impaired has been demonstrated in previous reports. 2,15 The present study demonstrated complete divergence of changes of longitudinal and circumferential systolic myocardial velocities both being independently related to the LV mass. Circumferential hyperfunction in systole found in interventricular septum may be a compensatory response to the impairment in LV longitudinal systolic performance allowing preservation of LV ejection fraction.…”

Section: Discussionmentioning

confidence: 76%

“…One study employing TDI did not show any differences in circumferential velocities between patients with HT and controls. 2 The results of the studies using analysis of LV fractional shortening are not uniformly concordant. 9,15,[20][21][22][23] Fractional shortening measured at the endocardium was unchanged or even increased in hypertensives; however, when midwall fractional shortening was assessed, besides normal values reported by some authors, depressed systolic function of circumferential layer of myocardial fibres was found out by others.…”

Section: Discussionmentioning

confidence: 93%

“…2,[16][17][18][19][20] Failure to evidence significant differences for circumferential IRTm might be related to difficulties in the proper identification of the beginning and the end of this time interval in the TDI curve in the short-axis view owing to greater number of artefacts than in the apical views. TDI proved the most sensitive and accurate method of evaluation of longitudinal circumferential function in the studied group with HT.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies employing echocardiographic tissue Doppler imaging (TDI) revealed in hypertensive patients besides LV diastolic disorders presence of subclinical systolic dysfunction of LV longitudinal myocardial fibres. 2,3 Moreover, as it was evidenced in some other cohorts alterations in LV circumferential function may not parallel those in longitudinal one. 4,5 Analogous data concerning function of circumferentially oriented myocardial fibres in hypertensive subjects are incomplete.…”

Section: Introductionmentioning

confidence: 99%

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Left ventricular circumferential function in patients with essential hypertension

2006

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The aim of the study was to investigate left ventricular (LV) systolic and diastolic circumferential myocardial function using tissue Doppler imaging in patients with essential hypertension. One hundred and two patients and 33 healthy age-matched controls were studied. Each patient underwent echocardiographic study with analysis of tissue velocity curves, which included mean peak systolic (Sm), early (Em) and late diastolic velocity (Am) and isovolumic relaxation time (IRTm). These parameters were expressed as means from the six basal segments of left ventricle reflecting its longitudinal function (L). The same indices estimated in mid-anteroseptal (C-AS) and mid-posterior (C-P) segments in parasternal short-axis view served as a measure of LV circumferential function. Higher value of C-AS-Sm and a similar trend in C-P-Sm suggest increased LV circumferential systolic function in hypertensive patients, whereas lower values of C-AS-Em, C-P-Em, C-AS-Em/Am and C-P-Em/Am indicate impaired LV circumferential diastolic function. Decreased L-Sm as well as decreased L-Em and L-Em/Am reflects LV longitudinal systolic and diastolic dysfunction, respectively. By univariate analysis, positive correlations were demonstrated between C-AS-Sm and LV mass index (LVMI) (r ¼ 0.61, Po0.001), interventricular septum thickness (IVS) (r ¼ 0.55, Po0.001) and LV posterior wall thickness (PW) (r ¼ 0.43, Po0.01) and negative ones between L-Sm and LVMI (r ¼ À0.51, Po0.001) and PW (r ¼ À0.36, Po0.04). By stepwise multivariate regression analysis, LVMI, IVS and age independently predicted C-AS-Sm and LVMI predicted L-Sm. Our study demonstrated in hypertensive patients increased LV circumferential systolic and decreased diastolic function. The former may be a compensatory response to the impairment in LV longitudinal systolic performance.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Left ventricular circumferential function in patients with essential hypertension

2006

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“…Pulse Doppler tissue imaging (DTI) is increasingly popular and has been advocated to complement the conventional method and pulmonary venous flow measurements. [35][36][37] The final expression of LVH probably involves complex interactions between mechanical, neurohormonal, metabolic (include body size), and genetic factors (include gender). From a pathophysiological viewpoint and considering the anatomical continuum between the periphery, central vessels and the LV, it is highly plausible that systemic CV risk factors such as high BP load can exert an 'insult' across all vascular beds, although not necessarily in a uniform manner.…”

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confidence: 99%

Insulin resistance and vascular remodelling, in relation to left ventricular mass, geometry and function: an answer to LIFE?

Lee

Lip

2003

J Hum Hypertens

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Many pathophysiological processes have been intimately linked to hypertension and its complications, including insulin resistance, left ventricular mass (LVM) and geometry, central vascular hypertrophy and peripheral vascular remodelling, LV systolic and diastolic function, etc. What appears to be much less certain are the (complex) interrelations between all these diverse processes.In elderly patients with essential hypertension and LV hypertrophy (LVH), Olsen et al 1 recently reported that peripheral vascular remodelling (assessed as minimal forearm vascular resistance, MFVR), hypertrophy and low distensibility of the common carotid arteries are associated with increased systolic blood pressure (BP) but not with insulin resistance (as assessed by euglycaemic hyperinsulinaemic clamp) or hyperinsulinaemia. Their findings suggest that long-standing systolic BP load may be a far more important determinant of structural vascular changes than insulin resistance in hypertension. However, in never-treated hypertensives, insulin resistance and hyperinsulinaemia were associated with low distensibility of the common carotid arteries, independent of BP and lumen diameter; perhaps because of a direct effect of insulin on the carotid arteries, resulting in changes in collagen metabolism. 1 Indeed, the subsequent publication from Olsen et al 2 suggests that insulin sensitivity was unrelated not only to parameters of peripheral vascular remodelling, but also to endothelial function or microvascular rarefaction.In this issue of the Journal of Human Hypertension, Olsen et al 3 examine the association between insulin resistance, carotid hypertrophy and peripheral vascular remodelling on the one hand and LVH, diastolic LV filling and systolic function on the other. So, what more information can the present analysis add to their previous two publications? 1,2 We shall (hopefully) delineate these in a systematic manner.LVH by echocardiography has proved to be a strong independent predictor of cardiovascular (CV) morbidity and mortality in hypertensive patients. Patients with a concentric hypertrophy geometry (increased LVM and relative wall thickness) appear to carry the highest risk, while an eccentric hypertrophy geometry (increased LVM but normal relative wall thickness) carries an intermediate risk for target organ damage. 4,5 In addition, the former is associated with especially high arterial pressure while the latter is associated with obesity and elevated volume load. On the other hand, central vascular hypertrophy, in particular carotid intimamedia thickness (IMT) is generally regarded as 'marker' of atherosclerotic burden as well as a 'predictor' of future CV events in prospective epidemiological studies. 6 Indeed, arterial remodelling, hypertrophy, and stiffness are common alterations in hypertensive patients, as well as LV diastolic dysfunction, and all have been linked to LVH. 7 However, diastolic dysfunction is also well recognised in patients with hypertension, even in the absence of LVH, but whether its assessment ...

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Impaired systolic dysfunction of left ventricular longitudinal fibers: A sign of early hypertensive cardiomyopathy

Koulouris¹,

Kostopoulos²,

Triantafyllou³

et al. 2005

Clin Cardiol

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SummaryBackground: Atrioventricular plane displacement (AVPD) study by M-mode echocardiography can supply useful clinical information about left ventricular (LV) long-axis function.Hypothesis: We assessed the hypothesis that AVPD estimation could be used to detect early hypertensive cardiomyopathy.Methods: The study population included 81 hypertensive patients with normal LV ejection fraction and fractional shortening, and 50 age-and gender-matched healthy controls. By utilizing M-mode and apical views, the following parameters were estimated: early mitral flow peak velocity (E) and deceleration time (DT), peak velocity of late mitral flow (A), A/E ratio, isovolumic relaxation time (IVRT), total AVPD, AVPD motion during atrial systole (At), systolic AVPD (total AVPDAt), and At/total AVPD ratio.

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Doppler Tissue Echocardiography: Myocardial Wall Motion Velocities in Essential Hypertension

Cited by 41 publications

References 17 publications

Left ventricular circumferential function in patients with essential hypertension

Left ventricular circumferential function in patients with essential hypertension

Insulin resistance and vascular remodelling, in relation to left ventricular mass, geometry and function: an answer to LIFE?

Impaired systolic dysfunction of left ventricular longitudinal fibers: A sign of early hypertensive cardiomyopathy

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