Key result
In hypertensive patients with normal ejection fraction, increased arterial stiffness significantly correlated with impaired early diastolic strain rate (r = -0.479, p < 0.001) and systolic global longitudinal strain (r = 0.300, p = 0.012).
Why the study?
Does arterial stiffness correlate with impaired regional myocardial function in patients with untreated hypertension and normal ejection fraction?
Cross-Sectional (n=70)
Does arterial stiffness correlate with impaired regional myocardial function in patients with untreated hypertension and normal ejection fraction?
Effect estimate: r = -0.479
p-value: p=<0.001
In patients with untreated hypertension and normal ejection fraction, increased arterial stiffness is associated with impaired systolic and diastolic regional myocardial function and diminished compensatory ventricular twist.
May signal early myocardial effects of stiffness in hypertension; hypothesis-generating, needing longitudinal data before clinical use.
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 (ε) 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 ε (r = 0.300, p = 0.012) and early diastolic SR (SR(E)) (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 ≤ 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.
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Hwang et al. (2012) conducted a cross-sectional in Untreated hypertension with normal ejection fraction (n=70). Arterial stiffness (Brachial-ankle pulse wave velocity) vs. Lower arterial stiffness was evaluated on Correlation between brachial-ankle pulse wave velocity and early diastolic strain rate (SRE) (r = -0.479, p=<0.001). In hypertensive patients with normal ejection fraction, increased arterial stiffness significantly correlated with impaired early diastolic strain rate (r = -0.479, p < 0.001) and systolic global longitudinal strain (r = 0.300, p = 0.012).
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