Effect of an Increase in Left Ventricular Pressure Overload on Left Atrial‐Left Ventricular Coupling in Patients with Hypertension: A Two‐Dimensional Speckle Tracking Echocardiographic Study

Miyoshi, Hirokazu; Oishi, Yoshifumi; Mizuguchi, Yukio; Iuchi, Arata; Nagase, Norio; Ara, Nusrat; Oki, Takashi

doi:10.1111/echo.12117

Cited by 32 publications

(35 citation statements)

References 28 publications

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“…However, in clinical practice, we do not routinely assess the different components of LA function, although this is now possible because of advances in noninvasive imaging techniques. Recent studies based on tissue Doppler imaging [9], vector velocity imaging (VVI) [10,11], or speckle tracking imaging (STE) [12][13][14][15][16] assessed LA function in patients with HTN with or without LV hypertrophy. However, literature data concerning LA strains in patients with HTN are conflicting.…”

Section: Introductionmentioning

confidence: 99%

“…However, literature data concerning LA strains in patients with HTN are conflicting. Left atrial reservoir function has been shown to be reduced [12,13] or normal in patients with LV hypertrophy [10,11], whereas it showed early impairment in some studies of HTN patients without hypertrophy [14][15][16]. LA conduit function has been more consistently shown to be reduced, regardless of LV mass [9][10][11]13,15,16].…”

Section: Introductionmentioning

confidence: 99%

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Hypertensive patients with left ventricular hypertrophy have global left atrial dysfunction and impaired atrio-ventricular coupling

Soullier

Niamkey

Ricci

et al. 2016

Journal of Hypertension

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hypertensive patients with left ventricular hypertrophy have global left atrial dysfunction and impaired atrio-ventricular coupling

Soullier

Niamkey

Ricci

et al. 2016

Journal of Hypertension

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“…Each cardiomyopathy disease(hypertrophic [68,75], restrictive [76,77], dilated [78], ischemic [79,80], hypertensive [81,82], arrhythmogenic right ventricular [83], myocarditis [84], left ventricular non-compaction [85,86]) each has validated pathophysiologic features that can confirm a risk state [52,87]. Averaged features have a very low incidence of false positives and false negatives results [9,14,48,50].…”

Section: Cardiomyopathiesmentioning

confidence: 99%

“…The essential pathophysiologic data used to depict the risk of hypertensive heart disease [81,82] and "pseudo-HCM" [48, 91,92] are identical to those of general cardiomyopathies [60] Table 1&2. Screening blood pressure and increased LVwall thickness serve only as benchmarks that require physiologic classification as normal compensatory physiology versus emergent heart disease [91].…”

Section: Hypertensive Heart Diseasementioning

confidence: 99%

“…Screening blood pressure and increased LVwall thickness serve only as benchmarks that require physiologic classification as normal compensatory physiology versus emergent heart disease [91]. The overlapping features of normal [9,54,93] myocardial remodeling can mimic the features of HCM, hypertensive heart disease, and infiltrative diseases [81,94]. These overlapping features have been referred to as the "gray zone".…”

Section: Hypertensive Heart Diseasementioning

confidence: 99%

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Part 2 - Sudden Cardiac Death in Athletes Focused Cause-and-Effect Screening

Paterick¹,

Choudhary²,

Chandrasekaran³

et al. 2015

JESO

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Echo/Doppler screening should be looked upon as a strategy used in a select population of healthy, asymptomatic individuals to identify pre-emergent disease. Using focused echo/Doppler screening the incidence of a cardiovascular finding in athletes has been reported to be roughly one case in every 170 athletes screened with a "false positive" finding in only 8 of 508 athletes [2,10,[13][14][15]. We describe how to provide a highest quality, exceptionally low cost pathophysiologic athletic screening test, which is validated to differentiate the status of a normal state from an abnormal life-threatening pathophysiologic state.Matching pre-emergent disease (without phenotypic expression) "associated" with sudden death through diastolic parameters is the key to differentiating normal from abnormal pathophysiology [5,9,[16][17][18][19][20][21][22][23][24]. These data are focused on two principal objectives: detect an imminent life-threatening state at a time when the opportunity for prevention is optimal [25,26], and define the magnitude of imminent risk that enlightens physician decision making and management [23,[26][27][28]. Rule-Out vs. Rule-in ScreeningA sensitive screening approach must be distinguished from a specific screening methodology [5,6]. The current trend in athletic screening is searching for an "abnormal" disease feature in a low risk population. This fact alone (searching for a specific rare event) is a major contributor to the controversies and shortfalls surrounding athletic screening [5,6].The most optimal screening test for a large, asymptomatic athletic population prioritizes testing to confirm wellness and rule out disease. An abnormality in screening would be referred for comprehensive evaluation. The rule out principle is important because the penalty for missing a disease has the potential for athletic death. This principle reduces the number of specific diseases to be considered during screening. All cardiomyopathies are grouped as having abnormal diastolic tissue Doppler examination. Conversely, ruling in a disease is more applicable when confirming a high frequency disease. Confirming wellness AbstractSudden death in an athlete is a tragic event. There is a strong social imperative to implement effective means of predicting and preventing sudden death in athletes. However, the design and implementation of a solution seems unobtainable [2]. Part Two discusses how novel attributes of systems biology and digital technology are capable of delivering high quality, low cost athletic screening. The merit of a transformative idea does not necessarily predict its adoption. The greatest barrier to change lies in the acquiescence to familiar practices even in light of new ideas and technology. The current thought in athletic screening is more centered on specific disease associations (rule-in principle), [3][4][5] and much less about the sensitivity of pathophysiologic causality (ruleout principle) [5][6][7][8].A solution will languish until the expert community takes direct action to embrace 21 s...

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Assessment of subclinical left atrial myocardial dysfunction in essential hypertension patients with normal left ventricle function by two‐dimensional strain and volume‐derived variables

Huang

Yang

et al. 2021

J of Clinical Ultrasound

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Purpose: To investigate subclinical left atrial (LA) myocardial dysfunction in essential hypertension (EHT) patients by using volume-derived and two-dimensional strain.Methods: We enrolled in this study 51 normal subjects and 95 EHT patients. The LA volume-derived index was measured in apical 4-and 2-chamber views. LA strain and strain rate, reservoir, conduit, and booster pump functions were measured by twodimensional speckle tracking echocardiography (STE).Results: LA ejection fraction (LAEF) and absolute strain-derived values were significantly lower in EHT patients than in controls. LAEF (total, passive), absolute values of LA strain (S-reservoir and S-conduit), and strain rate (Sr-reservoir and Sr-conduit) were significantly lower in EHT patients with left ventricular hypertrophy (LVH) than in patients without LVH and in controls. However, there were no significant difference in active LAEF or S-booster pump and Sr-booster pump functions between EHT patients without LVH and normal subjects. The areas under the curves of the combination of volume-derived values, LA strain, and strain rate were significantly higher than those of individual indices. Conclusion:In our population, EHT patients showed impaired LA functions and greater stiffness than normal subjects. EHT patients with LVH showed greater impairment of LA reservoir and conduit functions than patients without LVH. EHT patients without LVH had normal LA booster pump function, which was impaired in patients with LVH. Volume-derived and 2D strain values could provide a sensitive and reproducible method for detecting subclinical LA myocardial dysfunction in EHT.

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Effect of an Increase in Left Ventricular Pressure Overload on Left Atrial‐Left Ventricular Coupling in Patients with Hypertension: A Two‐Dimensional Speckle Tracking Echocardiographic Study

Cited by 32 publications

References 28 publications

Hypertensive patients with left ventricular hypertrophy have global left atrial dysfunction and impaired atrio-ventricular coupling

Hypertensive patients with left ventricular hypertrophy have global left atrial dysfunction and impaired atrio-ventricular coupling

Part 2 - Sudden Cardiac Death in Athletes Focused Cause-and-Effect Screening

Assessment of subclinical left atrial myocardial dysfunction in essential hypertension patients with normal left ventricle function by two‐dimensional strain and volume‐derived variables

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