Effect of an Increase in Global Left Ventricular Afterload on Myocardial Deformation in Patients with Aortic Stenosis, Comparison with Hypertensive Patients
Journal Title: Cardiology and Angiology: An International Journal - Year 2017, Vol 6, Issue 3
Abstract
Aims: Left ventricular hypertrophy (LVH) secondary to hypertension and aortic stenosis (AS) are often considered together to be pressure overload hypertrophy. We hypothesized that important differences could exist in the myocardial function with these 2 origins of pressure-overload LVH. Methods: Global LV longitudinal peak strain (GLS), circumferential strain (GCS) and peak left atrial (LA) longitudinal strain (PALS) were measured using speckle-tracking echocardiography in 38 hypertensive LVH (H-LVH) patients and 36 patients with severe AS and preserved LV ejection fraction. The ratio of E/Ea to PALS was used as an index of LA stiffness. To estimate the global LV afterload, we calculated the valvuloarterial impedance (Zva) as the sum of the systolic arterial pressure and the mean transvalvular pressure gradient divided by the stroke volume index. Results: The patients in the high Zva (n=49, Zva≥3mmHg ml/m2) were divided into two groups: AS group (n=28) and H-LVH group (n=21). GLS and PALS were significantly worsened in the AS group (p<0.0001 and p<0.0001, respectively). However, GCS was not significantly difference between two groups. LA stiffness was greater in the AS group than in the H-LVH group (p<0.0001). Conclusions: Despite of similar global LV afterload and LV hypertrophy, myocardial LV longitudinal systolic function and LA function are impaired in patients with severe AS compared with H-LVH patients.
Authors and Affiliations
Yoshikazu Ohara, Yuki Yoshimura, Yohko Fukuoka, Atsuko Furukawa, Shingo Hosogi, Katsuhito Yamamoto
Keywords
Related Articles
- EP ID EP305773
- DOI 10.9734/CA/2017/35862
- Views 97
- Downloads 0
Cardiac Computed Tomographic Angiography: Clinical Applications
Cardiovascular disease is the lead¬ing cause of morbidity and mor¬tality worldwide. Cardiac imaging plays an important role in diagnosis and risk stratification of various cardiac diseases. Cardiac computed tomography ad...
Carotid Intima-media Thickness and Risk of Cardiovascular Disease among Healthy Adult Volunteers in North Eastern Nigeria
Background: Assessment of carotid intima media thickness (CIMT) have evolved over the years to assume a key role in assessment of cardiovascular risk. However, there is paucity of data on CIMT among Nigerian. We assessed...
Role of Hs-CRP and Exercise Stress Echocardiography in Cardiovascular Risk Stratification of Asymptomatic Type 2 Diabetic Patients
Background: Silent ischaemia is a well known cause of mortality and morbidity in type-2 diabetic patients; however the role of high-sensitive C-Reactive Protein (hs-CRP) and exercise stress echocardiography in early dete...
Type 2 Diabetes and Myocardial Infarction in Central India: A Study and Review
Background: Clinical experience in specific geo-demographic contexts in diabetes and myocardial infarction (MI) deserves examination in the context of current medical knowledge and redefinition for enlightened evidence b...
Factors Influencing the Risk of Death among Patients with Heart Failure
The purpose of this study was to investigate the impact of risk factors on the death of patients with heart failure in a cohort of patients hospitalized with heart failure disease. In this paper we used chi-square tests...