Naslov
REGIONAL DIASTOLIC DYSFUNCTION AS EARLY MANIFESTATION OF HYPERTENSIVE HEART DISEASE

Autori
Separović-Hanževački, Jadranka ; Lovrić-Benčić, Martina ; Putarek, Krešimir ; Čikeš, Maja ; Biškup, Ivica ; Bobić, Lana ; Ernst, Aleksandar

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Journal of Echocardiography / J.R.T.C. Roelandt - London : Delhi : W.B. Saunders, 2004

Skup
Euroecho 2004

Mjesto i datum
Atena, Grčka, 01.12.2004. - 04.12.2004

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
diastolic dysfunction; tissue Doppler echocardiography; hypertension

Sažetak
Background: Global left ventricular diastolic dysfunction measured by Doppler mitral and pulmonary veins inflow is usual in hypertensive patients. In order to better understand the pathophysiological process and to diagnose subclinical myocardial changes it is necessary to assess regional diastolic function. We sought to analyze segmental myocardial relaxation using Tissue Doppler Imaging (TDI) in hypertensive patients (pts) with and without global diastolic dysfunction by conventional Doppler parameters. Methods: treated hypertensive pts (48&plusmn ; ; ; 7.3 yrs) with normal myocardial thickness and normal systolic function, were randomised in 2 groups according to blood pressure (BP) control from previous 24h BP monitoring. Group A: 28 pts with well control BP ; group B: 30 pts with uncontrolled BP. Pts and 11 healthy age match normals (n.) underwent TDI (E&#8217; , A&#8217; at annulus, base and middle segment (s.) of each wall in longitudinal views and basal posterior segments in short (SAX) and long axis (LAX)) and Doppler echocardiography (IVRT, PFVE, PFVA, DtE, Adur, PVA, PVAdur). For statistical analysis the non-parametric Mann-Whitney test was used. P value <0.05 &#61482; vs. control group and &#61475; vs. group B. Results: In group A parameters measured by Doppler echocardiography were normal, while TDI revealed regional impairment of relaxation: 1. E&#8217; /A&#8217; <1 was found in 4/21 s. or 19 % (in annular and basal s. of the lateral wall and basal s. in LAX and SAX: mean E&#8217; /A&#8217; = 0.82&#61617; 0.07, p=0.0017&#61482; . 2. All segments mean was: E&#8217; /A&#8217; = 1.03 &#61617; 0.02, n.s. In group B Doppler parameters shown impairment of relaxation: E/A = 0.92&#61617; 0.23&#61482; &#61475; DtE = 259&#61617; 85ms&#61482; &#61475; PVAdur/Adur = 0.82&#61617; 0.14&#61482; &#61475; . TDI values were indicated impairment of relaxation in a majority of segments: 1. All segments mean: E&#8217; /A&#8217; = 0.64&#61617; 0.12, p<0.01&#61482; , p<0.05&#61475; , 2. E&#8217; /A&#8217; <1 was found in 18/21 or 74 % of all s: (in basal s. of each wall and middle s. of septum and lateral walls: mean E&#8217; /A&#8217; =0.12&#61617; 0.09, p<0.0001&#61482; &#61475; ). Conclusion: Using TDI in hypertensive pts. regional diastolic dysfunction is found even in pts. with normal standard Doppler parameters. It seems that this is the earliest manifestation of hypertensive heart disease (while myocardium is not thickened and no sign of global diastolic dysfunction in standard Doppler parameters). These might have important clinical value in diagnosis of subclinical hypertensive heart disease and follow up of the treatment.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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