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Assessment of left ventricular systolic and diastolic function by tissue Doppler analysis in patients with
Yusuf Tavil1, Mehmet Gungor Kaya, Nihat Sen
1Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey. yusuftavil@gmail.com
Insights
Hyperuricemia (HU) worsens cardiac function in hypertensive patients. This study found impaired left ventricular (LV) function in hypertension with HU, correlating with serum uric acid levels.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Hyperuricemia (HU) is a known cardiovascular disease risk factor, but its independent association and role in hypertension-induced myocardial impairment are debated.
- Understanding HU's impact on cardiac function in hypertension is crucial for cardiovascular risk stratification.
Purpose of the Study:
- To assess left ventricular (LV) systolic and diastolic function in patients with hypertension (HT) with or without HU.
- To utilize Tissue Doppler Imaging (TDI) for detailed cardiac function analysis, given its superiority over conventional echocardiography.
Main Methods:
- The study included 27 patients with HT without HU, 27 with HT and HU, and 27 age-matched healthy controls.
- Echocardiography, including standard 2D, conventional Doppler, and TDI, was used to evaluate cardiac function.
- Key TDI parameters calculated included peak systolic myocardial velocity (Sm), mitral inflow velocities (Em, Am), and myocardial performance index (LV-MPI).
Main Results:
- Significant differences in mitral inflow and TDI-derived diastolic velocities were observed between patient groups and controls.
- LV-MPI was significantly impaired in both HT groups compared to controls (P<0.001).
- LV-MPI was also significantly different between HT patients with and without HU, with correlations found between serum uric acid and LV function parameters.
Conclusions:
- Hypertension with hyperuricemia is associated with impaired LV systolic and diastolic function.
- Serum uric acid levels correlate with LV dysfunction in hypertensive patients.
- TDI is a valuable tool for detecting subtle cardiac impairments in HU and HT.
Objective:
Hyperuricemia (HU) is a well-recognized risk factor for cardiovascular diseases. The independence of this association from other confounding factors has remained controversial. The possible contributory effect of HU to myocardial impairment produced by hypertension (HT), however, has not been clarified yet. The study was designed to assess the left ventricular (LV) systolic and diastolic function in patients with HT with or without HU. Tissue Doppler imaging (TDI) was used for detailed analysis as this method was superior to other conventional echocardiographic techniques.
Methods:
The study participants consisted of 27 patients (men 56%, mean age+/-SD; 55+/-10 years) with HT without HU, and 27 patients with HT with HU (men 62%, mean age+/-SD; 56+/-9 years), and 27 age-matched healthy control participants (men 57%, mean age+/-SD; 53+/-11 years). Cardiac functions were determined using echocardiography, comprising standard two-dimensional and conventional Doppler and TDI. Peak systolic myocardial velocity at mitral annulus (Sm), mitral inflow velocities and early diastolic mitral annular velocity (Em), late diastolic mitral annular velocity (Am), peak systolic mitral annular velocity, Em/Am, and myocardial performance index were calculated by TDI.
Results:
Mitral inflow velocities and tissue Doppler-derived mitral annular diastolic velocities were significantly different in the patient groups (HT without HU and HT with HU) compared with the control cases. Tissue Doppler-derived myocardial performance index (LV-MPI) was significantly impaired in the patient groups compared with those of the control's (0.48+/-0.09, 0.53+/-0.07, and 0.39+/-0.07, respectively, P<0.001). Significant differences were also observed between the patients who had HT without HU and the patients who had HT with HU regarding LV-MPI. Significant correlations were observed between the serum uric acid levels and LV function parameters.
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