Left ventricular diastolic properties of hypertensive patients measured by pulsed tissue doppler imaging

Oki, Takashi; Tabata, Tomotsugu; Yamada, Hirotsugu; Wakatsuki, Tetsuzo; Mishiro, Yuichiro; Abe, Miho; Onose, Yukiko; Iuchi, Arata; Ito, Susumu

doi:10.1016/s0894-7317(98)80005-9

Cited by 92 publications

(56 citation statements)

References 40 publications

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“…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%

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: 99%

Left ventricular circumferential function in patients with essential hypertension

2006

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“…The apical four-chamber view was chosen to obtain a quantitative assessment of the global diastolic left ventricular function, almost simultaneously to the Doppler left ventricular inflow, and to minimize the incidence angle between the Doppler beam and the longitudinal motion of the mitral annulus. 9,10 The detailed method was as described previously. 16 PW tissue Doppler of the septal annulus was used for the measurements of early peak diastolic mitral annulus velocity (E s ).…”

Section: Pulsed-wave Tissue Doppler Imagingmentioning

confidence: 99%

“…7 Indeed, long-standing obesity can induce left ventricular structural and functional abnormalities, characterized by volume overload and hyperdynamism, eccentric left ventricular hypertrophy, diastolic dysfunction and, occasionally, systolic dysfunction and heart failure. 8 Pulsed-Wave Tissue Doppler Imaging (PW-TDI) of the mitral annulus has demonstrated the capability to a relatively load-independent analysis of the global longitudinal myocardial 9,10 Color-Doppler Myocardial Imaging (CDMI) echocardiography-derived strain rate (SR) and strain measurements are new quantitative indices of regional intrinsic myocardial deformation. 11,12 In particular, strain and SR are relatively load independent, and this characteristic is very relevant in the obese population, in which a cardiac volume overload exists.…”

Section: Introductionmentioning

confidence: 99%

Relationship between preclinical abnormalities of global and regional left ventricular function and insulin resistance in severe obesity: a Color Doppler Imaging Study

et al. 2006

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Background: The aim of this study was to evaluate the relationship between insulin resistance and preclinical abnormalities of the left ventricular structure and function detected in severe obesity by Color Doppler Myocardial Imaging (CDMI). Forty-eight consecutive severely obese patients (Group O) (11 males, 37 females, mean age 32.877 years) were enrolled. Forty-eight sexand age-matched non-obese healthy subjects were also recruited as controls (Group C). All subjects underwent conventional 2D-Color Doppler echocardiography and CDMI. The homeostasis model assessment insulin resistance index (HOMA-IR) was used to assess insulin resistance results. Obese subjects had a greater left ventricular mass index (by height) (58.8714 g/m 2.7 ) than controls (3778 g/m 2.7 ) (Po0.0001), owing to compensation response to volume overload caused by a greater cardiac output (Po0.02). Preload reserve was increased in obese subjects, as demonstrated by a significant increase in left atrial dimension (Po0.0001). Obese patients had a slightly reduced LV diastolic function (transmitral E/A ratio: Group O, 1.170.8 vs Group C, 1.5 70.5; Po0.002). Cardiac deformation assessed by regional myocardial systolic strain and strain rate (SR) values was significantly lower (abnormal) in obese patients than in controls, both at the septum and lateral wall level. These strain and SR abnormalities were significantly related to body mass index. In addition, the early phase of diastolic function, evaluated using SR, was compromised in obese patients (Po0.001). The HOMA-IR values in obese patients were significantly higher (3.0971.6) than those determined in the control group (0.9270.5) (Po0.0001). The HOMA-IR values, in the obese group, were significantly related to systolic strain and SR values sampled at the septum level (Po0.0001). Conclusion: In conclusion, this study has demonstrated that obese patients pointed out systolic structural and functional abnormalities at a preclinical stage, in particular through strain and SR analysis; on the other hand, those altered CDMI parameters well distinguish obese subjects as compared with the control group. Furthermore, another main finding of the study was that myocardial deformation (systolic strain) could have a correlation with insulin resistance level.

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“…Several studies have demonstrated the lack of an effect of changes in preload on TDI parameters [63], no difference in TDI parameters along both the long and short axes at different preloads [64], correlations between TDI and pulmonary venous flow velocity parameters [65], correlations between TDI and M-mode color Doppler parameters [66], and correlations between TDI and hemodynamic parameters [67,68].…”

Section: Diastolic Functionmentioning

confidence: 99%

The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left Ventricular Function

Oki

2003

J Echocardiogr

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In general, pump function and myocardial contractility should be assessed when evaluating left ventricular (LV) systolic function. Ejection fraction obtained from left ventriculography is routinely used as an index of pump function, and the maximum value of the first derivative of LV pressure curve (peak dP/dt) has been used as an index of myocardial contractility. On the other hand, active relaxation of the LV myocardium during early diastole and LV passive filling or compliance during mid-to late diastole are important factors in evaluating LV diastolic function. To obtain this information, the time constant of the LV pressure decay during isovolumic diastole (tau) and LV end-diastolic pressure, which are calculated from the LV pressure curve recorded during cardiac catheterization, is used. However, invasive hemodynamic measurements cannot be performed in all patients, nor are they appropriate for follow-up evaluation involving repeated examinations.Recently, routine echocardiography has facilitated the noninvasive evaluation of LV systolic and diastolic function. The percent fractional shortening of the LV based on M-mode echocardiography and the LV ejection fraction determined by two-dimensional echocardiography are indices of LV pump function, and therefore cannot accurately evaluate LV myocardial contractility. On the other hand, "diastology" has become an important clinical topic [1]. There are several reasons why assessment of diastolic function is important: 1) 30 to 40% of patients evaluated for congestive heart failure have normal LV pump function [2,3]; 2) the transmitral flow velocity pattern, which is recorded using the pulsed Doppler method, may be an index for noninvasive evaluation of LV diastolic function [4]; and 3) the prognosis is poor in patients with LV systolic dysfunction and pseudonormalization or restrictive pattern of the transmitral flow velocity [5,6]. However, it has been shown that the diastolic indices obtained from transmitral and pulmonary venous flow velocities are influenced by loading conditions, especially by the pre- The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left AbstractThe widespread use of the pulsed Doppler echocardiography has facilitated the noninvasive evaluation of hemodynamic abnormalities of the left atrium and left ventricle (LV) based on transmitral and pulmonary venous flow velocity patterns. However, it has been shown that loading conditions, especially preload, influence the indices obtained from these velocity patterns. Recently, tissue Doppler imaging (TDI) has been applied to the clinical setting to assess LV myocardial function. In particular, this procedure has the following characteristics: 1) it can provide circumferential and longitudinal information for the LV myocardium; 2) the early diastolic LV myocardial parameters determined by TDI are not influenced by preload; 3) LV myocardial contractility can be evaluated from the early systolic parameters; 4) LV systolic and diastolic asynchrony can be detected; 5) myoca...

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Left ventricular diastolic properties of hypertensive patients measured by pulsed tissue doppler imaging

Cited by 92 publications

References 40 publications

Left ventricular circumferential function in patients with essential hypertension

Left ventricular circumferential function in patients with essential hypertension

Relationship between preclinical abnormalities of global and regional left ventricular function and insulin resistance in severe obesity: a Color Doppler Imaging Study

The Role of Tissue Doppler Imaging as a New Diagnostic Option in Evaluating Left Ventricular Function

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