No abstract

Aortic elastic properties can be directly assessed by measuring the movements in the upper aortic wall. Reduced aortic S velocity is associated with increased aortic stiffness in Type 1 diabetic patients.

hronic heart failure (CHF) has emerged as the most prevalent cause of mortality, morbidity and hospitalization in industrialized countries over the past years. 1 Despite the advances in medical and invasive treatment of CHF, its incidence is expected to rise in the future because of improved survival rates following acute myocardial infarction (MI), which is the principal etiology of CHF in >70% of patients. 2 Traditionally, great emphasis was put on evaluation of the various etiologic factors of this syndrome. Differentiation between ischemic cardiomyopathy (ICM) and idiopathic dilated cardiomyopathy (DCM) has important therapeutic implications because the former may gain substantial benefit from coronary revascularization. 3 Conventional echocardiography is commonly used for the evaluation of left ventricular (LV) and right ventricular (RV) function, but does not provide detailed information about myocardial systolic and diastolic properties in the regional segments. Tissue Doppler echocardiography (TDE) is a promising ultrasonographic technique that quantitatively measures the velocity of the myocardium in systole and diastole. 4 Traditionally, the principal target of the cardiologist is the evaluation of the LV function, with little interest in the RV. In spite of the fact that several recent studies have used the TDE technique in the assessment of RV function in various clinical conditions, 5,6 the literature on the RV and its impact on the pathophysiologic processes is limited. However, there is a growing body of evidence that RV function is a powerful predictor of mortality in patients with CHF. 7 We hypothesized that ICM and DCM differ in terms of RV function. Thus, the aim of our study was to investigate the RV function in patients with ICM and DCM using pulsed wave TDE and to compare the TDE parameters of the RV among the patients with ischemic and idiopathic dilated causes of LV dysfunction. Methods Study PopulationWe prospectively studied 82 consecutive patients with CHF who had undergone an echocardiographic examination at the AHEPA Hospital (Thessaloniki, Greece). CHF was defined as the presence of heart failure symptoms plus a dilated (>55 mm in end-diastolic diameter) LV with a depressed (<40%) ejection fraction of uncertain origin. The inclusion criteria were: (a) good quality echocardiographic imaging of tricuspid and mitral annular motion, (b) adequate tricuspid valve regurgitation Doppler signal in order to assess pulmonary artery systolic pressure, (c) sinus rhythm on electrocardiography (ECG), and (d) stable clinical condition. The following were considered as exclusion criteria:

LA strain and SR imaging improved after reduction of blood pressure with RAS inhibitors in hypertensive patients, whereas standard LA echocardiographic parameters remained unchanged. LA strain/SR values may have a role in detecting subclinical myocardial involvement in essential hypertension at an early stage; the association between change in these indexes after antihypertensive treatment and clinical outcome merits further evaluation.