Detection of the cardiac sequelae of hypertension plays an important role in the risk
assessment of patients with elevated arterial pressure. Prognosis may vary greatly
between groups of patients with similar blood pressures,
1
and differentiating among these groups is difficult. A common pattern among hypertensive
patients is impaired left ventricular (LV) diastolic function with preserved systolic
function, as measured by many conventional parameters, such as LV ejection fraction.
2
In contrast, systolic function along the ventricular long axis has been shown to
be abnormal in many hypertensive subjects, even when the LV ejection fraction is normal.
3
Analysis of mitral annulus motion (MAM) is the well-established method for assessing
long-axis ventricular function.
4
,
,
6
,
7
,
8
MAM has a proved incremental value to other conventional techniques in evaluating
diastolic and systolic function in hypertensive patients.
3
,
9
,
10
Measurement of annular motion also allows detection of postsystolic shortening (PSS)
along the LV long axis. This phenomenon has been observed with acute myocardial ischemia,
and also in hypertensive patients with LV hypertrophy.
- Rodriguez L.
- Garcia M.
- Ares M.
- Griffin B.P.
- Nakatani S.
- Thomas J.D.
Assessment of mitral annular dynamics during diastole by Doppler tissue imaging comparison with mitral Doppler inflow in subjects without heart disease and in patients
with left ventricular hypertrophy.
Am Heart J. 1996; 131: 982-987
11
,
- Jamal F.
- Szilard M.
- Kukulski T.
- Liu X.S.
- D’hooge J.
- Bijnens B.
- Rademakers F.
- Hatle L.
- Descheerder I.
- Sutherland G.R.
Changes in systolic and postsystolic wall thickening during acute coronary occlusion
and reperfusion in closed-chest pigs implications for the assessment of regional myocardial function.
J Am Soc Echocardiogr. 2001; 14: 691-697
12
,
13
To date, the potential importance of PSS in hypertensive heart disease has not been
well defined. Therefore, the aim of this study was (1) to show the extent of PSS along
the LV long axis in a group of hypertensive patients, and (2) to relate PSS to the
severity of hypertensive heart disease.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Midwall left ventricular mechanics. An independent predictor of cardiovascular risk in arterial hypertension.Circulation. 1996; 93: 259-265
- Left ventricular mass and function in primary hypertension.Am J Hypertens. 1996; 9: 55S-59S
- Echocardiographic assessment of left ventricular ejection fraction in left ventricular hypertrophy.Heart. 1999; 82: 192-198
- Assessment by echocardiogram of left ventricular diastolic function in healthy subjects using the atrioventricular plane displacement.Am J Cardiol. 1992; 69: 565-568
- Long axis function in disease.Heart. 1999; 81: 229-231
- M-mode analysis of mitral annulus motion for detection of pseudonormalization of the mitral inflow pattern.Am J Cardiol. 1999; 84: 692-697
- Right ventricular function in patients with first inferior myocardial infarction.Am Heart J. 2000; 139: 710-715
- The relation between mitral annulus motion and ejection fraction.J Am Soc Echocardiogr. 2000; 13: 896-901
- How should we assess diastolic function in hypertension?.Scand Cardiovasc J. 2000; 34: 377-383
- Assessment of mitral annular dynamics during diastole by Doppler tissue imaging.Am Heart J. 1996; 131: 982-987
- Changes in systolic and postsystolic wall thickening during acute coronary occlusion and reperfusion in closed-chest pigs.J Am Soc Echocardiogr. 2001; 14: 691-697
- Postsystolic shortening in ischemic myocardium.Circulation. 2002; 106: 718-724
- Amplitudes, durations, and timings of apically directed left ventricular myocardial velocities.J Am Soc Echocardiogr. 1998; 11: 112-118
- Recommendations for quantitation of the left ventricle by two-dimensional echocardiography.J Am Soc Echocardiogr. 1989; 2: 58-68
- Echocardiographic assessment of left ventricular hypertrophy.Am J Cardiol. 1986; 57: 450-458
- Computerised analysis of mitral annulus motion.Comput Med. 1999; 1: 128-133
- The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads.Am Heart J. 1949; 37: 161-186
- Pulmonary venous flow velocities recorded by transthoracic Doppler ultrasound.J Am Coll Cardiol. 1993; 21: 1697-1700
- Hypertension, hypertrophy, hormones, and the heart.Am Heart J. 1998; 135: S16-S20
- Functional importance of the long axis dynamics of the human left ventricle.Br Heart J. 1990; 63: 215-220
Article info
Publication history
Accepted:
March 3,
2003
Received in revised form:
March 3,
2003
Received:
November 21,
2002
Footnotes
☆This study was supported in part by the Institute of Cardiology of Kaunas Medical University, Kaunas, Lithuania; the Swedish Heart and Lung Foundation, Grant 9481 from the Swedish Medical Research Council, and CORTECH, a Swedish university network for advanced engineering and technologies in cardiovascular medicine supported by the Swedish Foundation for Strategic Research.
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
