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Left ventricular systolic and diastolic dyssynchrony in asymptomatic hypertensive patients

Sung-A Chang1, Hyung-Kwan Kim, Dae-Hee Kim

  • 1Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|March 10, 2009
PubMed

Insights

Systolic and diastolic dyssynchrony are common in asymptomatic hypertensive patients, indicating early heart changes. These conditions are linked to elevated left ventricular filling pressures and have distinct underlying mechanisms.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Hypertension Research

Background:

  • Diastolic and systolic dyssynchrony are prevalent in heart failure patients.
  • Dyssynchrony in asymptomatic hypertensive individuals, a high-risk group for heart failure, remains poorly understood.
  • Hypertension is a significant risk factor for developing heart failure.

Purpose of the Study:

  • To determine the prevalence of left ventricular (LV) systolic and diastolic dyssynchrony in asymptomatic hypertensive patients.
  • To identify key factors influencing LV dyssynchrony in this population.

Main Methods:

  • Compared 110 hypertensive patients with 55 healthy controls using comprehensive echocardiography.
  • Utilized Doppler tissue imaging and calculated LV end-systolic wall stress.
  • Assessed LV dyssynchrony via standard deviation and maximal difference of time from QRS onset to peak systolic velocity.

Main Results:

  • Hypertensive patients showed significantly higher systolic and diastolic dyssynchrony indexes than controls (P < .001).
  • 24% of hypertensive patients had LV systolic dyssynchrony, and 21% had LV diastolic dyssynchrony.
  • E/E' ratio independently predicted LV systolic dyssynchrony, while LV mass index and E/E' predicted LV diastolic dyssynchrony.

Conclusions:

  • Left ventricular systolic and diastolic dyssynchrony are common in asymptomatic hypertension and linked to elevated LV filling pressures.
  • Distinct determinants for systolic and diastolic dyssynchrony suggest different underlying pathophysiological mechanisms.
  • Early detection of dyssynchrony in hypertension may aid in predicting heart failure risk.
Abstract

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