Reduced First-Phase Ejection Fraction and Sustained Myocardial Wall Stress in Hypertensive Patients With Diastolic Dysfunction: A Manifestation of Impaired Shortening Deactivation That Links Systolic to Diastolic Dysfunction and Preserves Systolic Ejection Fraction
| Autor: | Gu, Haotian, Li, Ye, Fok, Henry, Simpson, John, Kentish, Jonathan C., Shah, Ajay M., Chowienczyk, Philip J. |
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| Rok vydání: | 2016 |
| Předmět: |
Heart Failure
Adult Male Systole Heart Ventricles blood pressure Heart Stroke Volume Original Articles Middle Aged Echocardiography Doppler Ventricular Function Left Article Ventricular Dysfunction Left Diastole Hypertension ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Ventricular Pressure echocardiography ventricular function Humans Female |
| Zdroj: | Hypertension (Dallas, Tex. : 1979) |
| ISSN: | 1524-4563 |
| Popis: | Supplemental Digital Content is available in the text. Impaired shortening deactivation of cardiac myocytes could sustain myocardial contraction, preserving ejection fraction at the expense of diastolic dysfunction. We examined the relationship between first-phase ejection fraction (EF1), the fraction of left ventricular volume ejected from the start of systole to the time of the first peak in left ventricular pressure (corresponding to the time of maximal ventricular shortening) to the duration of myocardial contraction and diastolic function in patients with hypertension (n=163), and varying degrees of diastolic dysfunction. Left ventricular systolic pressure was estimated by carotid tonometry; time-resolved left ventricular cavity and wall volume were obtained by echocardiography with speckle wall tracking. Measurements were repeated after nitroglycerin, a drug known to influence ventricular dynamics, in a subsample (n=18) of patients. EF1 and time of onset of ventricular relaxation (as determined from the temporal pattern of myocardial wall stress) were independently correlated with diastolic relaxation as measured by tissue Doppler early diastolic mitral annular velocity (E′, standardized regression coefficients 0.48 and −0.34 for EF1 and time of onset of ventricular relaxation, respectively, each P |
| Databáze: | OpenAIRE |
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