Impact of Arterial Stiffness on Regional Myocardial Function Assessed by Speckle Tracking Echocardiography in Patients with Hypertension.
- Author:
Jung Won HWANG
1
;
Soo Jin KANG
;
Hong Seok LIM
;
Byung Joo CHOI
;
So Yeon CHOI
;
Gyo Seung HWANG
;
Myeong Ho YOON
;
Joon Han SHIN
;
Seung Jea TAHK
Author Information
- Publication Type:Original Article
- Keywords: Arterial stiffening; Regional myocardial function; Speckle tracking echocardiography
- MeSH: Axis, Cervical Vertebra; Blood Pressure; Body Mass Index; Echocardiography; Humans; Hypertension; Myocardium; Pulse Wave Analysis; Relaxation; Sprains and Strains; Track and Field; Vascular Stiffness
- From:Journal of Cardiovascular Ultrasound 2012;20(2):90-96
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Arterial stiffening may affect regional myocardial function in hypertensive patients with normal ejection fraction (EF). METHODS: Brachial-ankle pulse wave velocity (PWV) was measured in 70 patients, of mean age 48 +/- 14 years, with untreated hypertension and EF > 55%. Using two-dimensional-speckle tracking echocardiography, we measured longitudinal and circumferential strain (epsilon) and strain rate (SR). Basal and apical rotations were measured using short axis views. RESULTS: The mean systolic and diastolic blood pressure in these patients was 152 +/- 15 mmHg and 92 +/- 11 mmHg, respectively. The mean value of PWV was 1578 +/- 274 cm/s. PWV significantly correlated with age (r = 0.682, p < 0.001), body mass index (r = -0.330, p = 0.005), systolic blood pressure (r = 0.386, p = 0.001) and pulse pressure (r = 0.509, p < 0.001). PWV also significantly correlated with septal E' velocity (r = -0.570, p < 0.001), E/A ratio (r = -0.414, p < 0.001), E/E' ratio (r = 0.589, p < 0.001), systolic global longitudinal epsilon (r = 0.300, p = 0.012) and early diastolic SR (SRE) (r = -0.479, p < 0.001) suggesting impaired abnormal relaxation. PWV was also correlated with basal rotation (r = -0.301, p = 0.011) and basal-to-apical twist (r = -0.256, p = 0.032). The increases in apical rotation and basal-to-apical twist were attenuated in patients with PWV > 1700 cm/s compared to those with PWV < or = 1400 cm/s or those with PWV 1400-1700 cm/s. CONCLUSION: In hypertensive patients with normal ejection fraction, arterial stiffening contributes to impaired systolic and diastolic function of the regional myocardium. Compensatory increases in ventricular twist were diminished in patients with advanced stage of vascular stiffening.
