Abstract 11808: Association Between Left Ventricular Properties in Patients With Hypertension and the Incidence of Paroxysmal Atrial Fibrillation: Three-Dimensional Speckle Tracking Echocardiographic Study

Autor: Masafumi Kawade, Masanori Kawasaki, Shingo Minatoguchi, Ryuhei Tanaka, Maya Ishiguro, Noriaki Sato, Maki Nagaya, Mayumi Kaneda, Hiroto Yagasaki, Yoshiaki Goto, Makoto Iwama, Takeshi Hirose, Koji Ono, Masazumi Arai, Toshiyuki Noda, Sachiro Watanabe, Shinya Minatoguchi
Rok vydání: 2014
Předmět:
Zdroj: Circulation. 130
ISSN: 1524-4539
0009-7322
Popis: Background: Hypertension (HTN) is one of the major causes of atrial fibrillation (AF), since it is usually accompanied by left atrial (LA) remodeling due to pressure and/or volume (LAV) overload. We examined the relationship between ventricular (LV) geometry or LV properties in HTN and the incidence of paroxysmal AF (PAF) using novel, one-beat, automated, 3-dimensional speckle tacking echocardiography (3D-STE) with high volume rates. Methods: Patients with HTN (n=107, age 69±7) and controls (n=60, age 69±9) were prospectively enrolled. HTN patients were divided into 5 groups according to LV geometry and the presence of hypertensive heat failure (HHF) {normal geometry (n=25), concentric remodeling (n=20), concentric hypertrophy (LVH) (n=24), eccentric LVH (n=21) and HHF (n=17)}. Isovolumic relaxation time (IVRT) was measured by Doppler echo. We evaluated LV ejection fraction (EF), E/e’, pulmonary capillary wedge pressure (PCWP), Tau, LV diastolic stress, LV strain and LV myocardial stiffness in sinus rhythm. PCWP was estimated as 10.7- 12.4 x log (LA active emptying function / minimum LAV) as we reported. Tau was calculated as IVRT / (ln 0.9 x systolic blood pressure - ln PCWP). LV diastolic stress was calculated as LV radius at end diastole x PCWP / thickness. LV strain rate (SR) during IVR, as an index of relaxation, and LV strain were measured by the 3D-STE with volume rates of 50-80vps. LV myocardial stiffness was estimated as LV stress / LV strain. Results: LVEF was reduced only in HHF compared with controls (56±7 vs. 67±6%). Conclusion: LVEF in HHF was decreased but still remained within the normal range, whereas diastolic properties in eccentric LVH and HHF were reduced compared with control. The incidence of PAF significantly increased in eccentric LVH and HHF associated with the impairment of LV relaxation and stiffness and increased LV stress. This suggests that the target of treatment to reduce the incidence of PAF in HTN must be diastolic function.
Databáze: OpenAIRE
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