Association between Left Ventricular Postsystolic Shortening and Diastolic Relaxation in Asymptomatic Patients with Systemic Hypertension

作者：Nogi Shimpei; Ito Takahide^*; Kizawa Shun; Shimamoto Shinsaku; Sohmiya Koichi; Hoshiga Masaaki; Ishizaka Nobukazu

来源：Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques, 2016, 33(2): 216-222.

DOI：10.1111/echo.13022

• hypertension
• myocardial function
• postsystolic shortening
• diastolic function
• speckle tracking

BackgroundFew data have existed on myocardial postsystolic shortening (PSS) accounting for left ventricular (LV) diastolic dysfunction in systemic hypertension. We examined this relationship, along with clinical and other cardiac parameters, in asymptomatic patients with hypertension.
MethodsWe analyzed 104 patients on pharmacological treatment for hypertension who had no signs or symptoms of heart failure for conventional and speckle tracking echocardiography. The sum of the postsystolic index for multiple LV segments (total PSI) and global longitudinal strain (GLS) was computed and used as measures for global PSS and myocardial systolic function, respectively. The tissue Doppler e' and the speckle tracking-derived global strain rate during early diastole (e'sr) were obtained as indicators of LV relaxation. The circumferential end-systolic stress was also determined noninvasively and substituted for a measure of myocardial afterload.
ResultsMain variables that correlated with the e' and e'sr were shown to be age, LV mass index, left atrial volume index, GLS, and the total PSI. Multivariate analysis including gender, circumferential end-systolic stress, and the use of calcium channel blockers as possible covariates revealed that age (=-0.29, P=0.002), total PSI (=-0.26, P=0.008), and LV mass index (=-0.25, P=0.017) were significant independent determinants of e' and that age (=-0.34, P<0.001) and GLS (=-0.28, P=0.006) were of e'sr.
ConclusionsOur findings indicate that while depending on the degree of GLS, PSS may affect diastolic relaxation in patients with asymptomatic, but treated, hypertensive patients.

• 出版日期2016-2