Skip Navigation


European Journal of Echocardiography Advance Access originally published online on April 4, 2008
European Journal of Echocardiography 2008 9(6):741-747; doi:10.1093/ejechocard/jen133
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
9/6/741    most recent
jen133v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Pavlopoulos, H.
Right arrow Articles by Nihoyannopoulos, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pavlopoulos, H.
Right arrow Articles by Nihoyannopoulos, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Is it only diastolic dysfunction? Segmental relaxation patterns and longitudinal systolic deformation in systemic hypertension

Harry Pavlopoulos*, Julia Grapsa, Ellie Stefanadi, Elena Philippou, David Dawson and Petros Nihoyannopoulos

Echocardiography Department, Imperial College of Medicine and Technology, National Heart and Lung Institute (NHLI), Hammersmith Hospital, Du Cane Road, W12 0HS London, UK

Received 26 November 2007; accepted after revision 2 March 2008; online publish-ahead-of-print 4 April 2008.

* Corresponding author. Tel: +44 208 743 0121; fax: +44 208 383 4392. E-mail address: drpavlo{at}yahoo.com


  Abstract

Aims: To investigate changes in longitudinal systolic function estimated by strain echocardiography in relation to global diastolic dysfunction and alterations in segmental relaxation patterns.

Methods and results: We studied 75 hypertensive patients, of whom 45 had diastolic dysfunction and normal EF, and 30 matched controls. All subjects had 2D and colour Doppler myocardial imaging. Mean longitudinal strain (S) and strain rate (SR) were averaged from the basal and mid-LV segments assessed in the longitudinal axis. Early to late diastolic SR ratio <1.1 was defined as altered segmental relaxation [segmental diastolic dysfunction (DD)]. The total number of segmental DD out of the 18 basal-mid-apical segments was calculated for all the participants. Longitudinal systolic function estimated by mean strain and SR was decreased in the hypertensive group, but was further deteriorated in the diastolic dysfunction group compared with controls. Altered Segmental Relaxation was highly correlated with longitudinal systolic dysfunction expressed by strain (r: –0.56)or SR (r: –0.57). A septal mitral annular Ea cut-off of 5.9 cm/s predicted longitudinal systolic dysfunction with a sensitivity of 81% and a specificity of 70%. A multiple linear regression model proved LVMI, systolic blood pressure (SBP) and age as independent predictors of diastolic and longitudinal systolic dysfunction and BMI to independently related to diastolic dysfunction.

Conclusion: Longitudinal systolic dysfunction may be present in hypertensive patients with diastolic dysfunction, especially when septal Ea < 5.9 cm/s. Altered segmental relaxation pattern is highly correlated with longitudinal systolic dysfunction. LV hypertrophy, SBP and aging are important determinants of both diastolic and longitudinal systolic dysfunction, whereas obesity appears to contribute to the appearance of diastolic dysfunction.

Keywords: Strain; Diastolic dysfunction; Hypertension


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 HeartHome page
I Ikonomidis, S Tzortzis, J Lekakis, I Paraskevaidis, I Andreadou, M Nikolaou, T Kaplanoglou, P Katsimbri, G Skarantavos, P Soucacos, et al.
Lowering interleukin-1 activity with anakinra improves myocardial deformation in rheumatoid arthritis
Heart, September 15, 2009; 95(18): 1502 - 1507.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.