Concentric left ventricular hypertrophy brings deterioration of systolic longitudinal, circumferential, and radial myocardial deformation in hypertensive patients with preserved left ventricular pump function

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

doi:10.1016/j.jjcc.2009.07.006

Cited by 130 publications

(135 citation statements)

References 48 publications

(62 reference statements)

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“…Global LV peak early diastolic longitudinal strain rate may have provided more accurate assessment of LV diastolic function. Third, it has been reported that LV systolic function in the longitudinal direction is impaired in hypertensive patients with not only reduced EF but also preserved EF (Mizuguchi et al 2010). Therefore, data from agematched normal control group may be needed to clarify association between arterial stiffness and LV function.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, data from agematched normal control group may be needed to clarify association between arterial stiffness and LV function. Finally, LV systolic function should be evaluated by the sum of longitudinal, circumferential, and radial deformation (Mizuguchi et al 2010). Further studies including data of LV longitudinal, circumferential, and radial directions may be needed to clarify association between CAVI and LV function.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Arterial Stiffness to Left Ventricular Function in Patients with Reduced Ejection Fraction

Noguchi

Masugata

Senda

et al. 2011

Tohoku J. Exp. Med.

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Heart failure has been divided into heart failure with preserved left ventricular (LV) ejection fraction (EF) and heart failure with reduced EF, because the pathophysiologies of the two conditions are different. Cardio-ankle vascular index (CAVI) is a new indicator of arterial stiffness, and the most conspicuous feature of CAVI is its independence of blood pressure at the time of measurement. Arterial stiffness has been considered to increase LV afterload, which requires special care to avoid the onset of heart failure. We compared the correlation of arterial stiffness as assessed by CAVI to LV function in 44 hypertensive patients with preserved EF (EF: 71 ± 7%) and 31 patients with reduced EF (48 ± 8%). All of patients with reduced EF had history of both hypertension and myocardial infarction. Using Doppler echocardiography, LV diastolic and systolic function was evaluated by measuring peak early diastolic mitral annular velocity (e') and global LV peak systolic longitudinal strain (GPSLS), respectively. In patients with preserved EF, CAVI was correlated with e' (r = −0.313, p = 0.038), but not with GPSLS (r = 0.207). By contrast, CAVI was correlated with GPSLS (r = 0.604, p < 0.001) as well as e' (r = −0.393, p = 0.029) in patients with reduced EF. Thus, patients with reduced EF showed a closer correlation of arterial stiffness to LV function compared with patients with preserved EF. Therefore, hypertensive patients with reduced EF require a stricter regimen for treating arterial stiffness than their counterparts with preserved EF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Correlation of Arterial Stiffness to Left Ventricular Function in Patients with Reduced Ejection Fraction

Noguchi

Masugata

Senda

et al. 2011

Tohoku J. Exp. Med.

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“…4,5) However, few data are available on use and outcome studied with conventional echocardiography in the evaluation of LA-LV interaction in asymptomatic patients in the community. Angle-independent two-dimensional speckle-tracking echocardiography (2DSTE) has recently been introduced into clinical practice because it offers early detection of impaired LA reservoir function 6,7) and LV contraction and relaxation 8,9) in subclinical patients with CVR factors. We hypothesized that comorbid conditions of CVR factors would be associated with worse LA-LV interaction, probably providing a potential explanation for the development to HFPEF in future.…”

Section: 2)mentioning

confidence: 99%

“…8,9) The basal short-axis view contained the mitral valve, the mid short-axis view contained the chordae tendineae, and the apical short-axis view was acquired distal to the papillary muscles. At each plane, 3 consecutive cardiac cycles were acquired at end-expiration breath holding and stored digitally on a hard disk for offl ine analysis.…”

Section: Wall Strainmentioning

confidence: 99%

Influence of Comorbid Cardiovascular Risk Factors on Left Atrial-Left Ventricular Interaction in Asymptomatic Patients

et al. 2014

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SummaryPrevious studies have examined the negative impacts of individual cardiovascular risk (CVR) factors on left atrial (LA)-left ventricular (LV) interaction, whereas the combined effects of these risk factors are insuffi ciently elucidated. We studied 176 asymptomatic patients with CVR factors and age-matched 50 healthy individuals by conventional and 2-dimensional speckle-tracking echocardiography. The patients were classifi ed into 2 groups according to the number of CVR factors: one risk factor (single) group (n = 79) and 2 or more risk factors (comorbid) group (n = 97). The peak early diastolic transmitral fl ow velocity (E)/peak early diastolic mitral annular motion velocity (e')/peak systolic LA strain (SLAs) was used as a surrogate for LA stiffness during ventricular systole. The E/e'/S-LAs was greatest in the comorbid group. The peak systolic LV circumferential and radial strains, peak early diastolic LV radial strain rate, and peak early diastolic LA strain and strain rate were lower in the comorbid group than in the single group. Multivariate regression analysis identifi ed age, body mass index, systolic blood pressure, end-systolic LV diameter, peak systolic mitral annular motion velocity (s'), and peak systolic LV radial strain in the comorbid group, and peak atrial systolic transmitral fl ow velocity and s' in the single group, as independent predictors of E/e'/S-LAs. Subtle LA and LV dysfunction with individual CVR factors were more aggravated with the comorbid conditions in asymptomatic patients. (Int Heart J 2014; 55: 138-145) Key words: LA diastolic stiffness, LA-LV interaction, 2-D speckle-tracking echocardiography I t is now recognized that approximately one-half of patients with the clinical syndrome of congestive heart failure (HF) have preserved systolic function, a condition referred to as HF with preserved ejection fraction (HFPEF). 1,2)The prevalence of this disease condition is anticipated to increase in elderly patients with cardiovascular risk (CVR) factors such as hypertension, diabetes, dyslipidemia, obesity, and smoking.2,3) Therefore, it is expected that a higher comorbid burden of the CVR factors is an important contributor to the development of HFPEF. Assessment of left atrial (LA) and left ventricular (LV) function, which we named as LA-LV interaction, 4) seems to have a clinical impact, because an abnormal LA-LV interaction is a mechanism responsible for producing congestion symptom. 4,5) However, few data are available on use and outcome studied with conventional echocardiography in the evaluation of LA-LV interaction in asymptomatic patients in the community. Angle-independent two-dimensional speckle-tracking echocardiography (2DSTE) has recently been introduced into clinical practice because it offers early detection of impaired LA reservoir function 6,7) and LV contraction and relaxation 8,9) in subclinical patients with CVR factors. We hypothesized that comorbid conditions of CVR factors would be associated with worse LA-LV interaction, probably providing a potent...

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“…13,14) Although there are studies that included circumferential or radial strain values, most were cross-sectional and did not examine intra-patient variation, which can be obtained only from serial echocardiography. [15][16][17][18][19][20] Among these cross-sectional studies, Kouzu, et al showed that LV radial strain was augmented to compensate for the decrease in longitudinal function and maintain stroke volume in early subclinical hypertensive heart disease. 21) Ng, et al reported that radial strain and strain rate were preserved in mild and moderate aortic stenosis and significantly decreased in severe AS.…”

Section: -7)mentioning

confidence: 99%

Patterns of Decrease in Multidirectional Myocardial Deformations in Patients With Fluctuating Left Ventricular Ejection Fraction

et al. 2014

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SummaryFew studies have examined the variations in longitudinal/circumferential/radial strain (LS/CS/RS) and strain rate (LSr/CSr/RSr) in individual hearts when the left ventricular ejection fraction (LVEF) has changed. We hypothesized the relationships of strain/strain rate and LVEF are not linear, but vary with multiple inflection points (IPs) in individual hearts.Twenty-five patients with fluctuating LVEF (ΔLVEF > 10%) who had 2-D speckle tracking echocardiography available for analysis were enrolled. After models of best fit were obtained from the 'collective' plots to determine inflection points, the decrements of slopes above inflection points (IP) were compared with those below IPs in the 'individual hearts' plots.In the 'collective' plots, both LS and LSr linearly decreased in proportion to LVEF when LVEF ≥ 40% but remained constant regardless of LVEF when LVEF < 40% (IPs when LVEF = 40%, P < 0.0001). The RS-LVEF relationship was sigmoid with two IPs when LVEF = 30% and 50% (P < 0.0001). However, in the 'individual hearts' plots, the decrements of slopes above and below IPs were not different for LS-LVEF and LSr-LVEF, and marginally different for RS-LVEF (P = 0.049, across IP when LVEF = 50%).Collectively, the relationship of LS/LSr/RS and LVEF seemed to be not linear, but inflective, however, we could not prove the inflective relationship in individual hearts with fluctuating LVEF. Further study with more patients is needed to prove our hypothesis. (Int Heart J 2014; 55: 319-325) Key words: Heart failure, Myocardial strain, Strain rate imaging L eft ventricular (LV) systolic work is produced by a combination of the following 3-dimensional myocardial deformations: longitudinal, circumferential and radial strain.Longitudinal strain and strain rate can be measured by Doppler tissue velocity imaging (TVI), which seems superior to conventional echocardiographic parameters at predicting LV systolic dysfunction in various cardiac diseases. 1-3)Since the introduction of 2-dimensional speckle tracking echocardiography (2DSTE) to the field of cardiac imaging, radial and circumferential strain can be analyzed in addition to longitudinal strain. Furthermore, early detection of ischemic heart disease and various cardiomyopathies is now feasible with 2DSTE. 4-7)Despite these advances, the variations in multidirectional myocardial deformations in individual hearts with fluctuating LV systolic function have not yet been fully elucidated.We previously described a different pattern of multidirectional impairment in doxorubicin-induced cardiomyopathy models in rats, 8) and tried to prove a similar pattern of impairment in human subjects in the current study, by investigating functional changes in each LV axis by analyzing longitudinal/ circumferential/radial strain (LS/CS/RS) and strain rate (LSr/ CSr/RSr) of LV with fluctuating LVEF.We also hypothesized the decrements in strain and strain rate are not constant but inflective as LVEF decreases, and the patterns of decrease in longitudinal strain/strain rate are different ...

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Concentric left ventricular hypertrophy brings deterioration of systolic longitudinal, circumferential, and radial myocardial deformation in hypertensive patients with preserved left ventricular pump function

Abstract: C-LVH caused deterioration of the systolic longitudinal, circumferential, and radial myocardial deformation in patients with HT. LV torsion and circumferential shortening were considered to be compensatory mechanisms for maintaining LV pump function.

Cited by 130 publications

References 48 publications

Correlation of Arterial Stiffness to Left Ventricular Function in Patients with Reduced Ejection Fraction

Correlation of Arterial Stiffness to Left Ventricular Function in Patients with Reduced Ejection Fraction

Influence of Comorbid Cardiovascular Risk Factors on Left Atrial-Left Ventricular Interaction in Asymptomatic Patients

Patterns of Decrease in Multidirectional Myocardial Deformations in Patients With Fluctuating Left Ventricular Ejection Fraction

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