title: The role of isovolumic acceleration in predicting subclinical right and left ventricular systolic dysfunction in hypertensive obese patients.
abstract: OBJECTIVE
  Isovolumic acceleration assessed by tissue Doppler imaging has been proposed as a preload-independent indicator of left ventricular contractility. We investigated the utility of isovolumic acceleration in the prediction of preclinical right and left ventricular systolic dysfunction in hypertensive and obese subjects.
  
  
  METHODS
  Seventy-eight obese subjects (BMI >30 kg/m2; 57 women, 21 men; mean age 51±8 years) were prospectively enrolled. Fifty patients (64.1%) had hypertension and 33 patients (42.3%) had diabetes mellitus. All the subjects were assessed by conventional and tissue Doppler echocardiography. Myocardial velocities of the left ventricular septal and lateral mitral annulus and lateral tricuspid annulus were determined. Isovolumic contraction wave was defined as the preceding wave of the systolic wave that began before the peak of the R wave on the electrocardiogram. Myocardial isovolumic acceleration was measured by dividing the peak velocity by the time passed from the onset of the wave (zero-crossing) during isovolumic contraction to the peak velocity of the wave.
  
  
  RESULTS
  Waist circumference was in positive correlation with left ventricular end-systolic (r=0.22, p=0.047) and end-diastolic (r=0.384, p=0.001) diameters, and in negative correlation with the peak systolic velocity of the tricuspid annulus (r=-0.311, p=0.006). Although hypertensive and normotensive (n=28) obese subjects had similar myocardial velocities, lateral tricuspid annular isovolumic acceleration (p=0.027), septal isovolumic acceleration (p=0.026), and septal isovolumic contraction myocardial velocity (p=0.018) were significantly lower in hypertensive patients.
  
  
  CONCLUSIONS
  Isovolumic acceleration and isovolumic contraction myocardial velocity analysis may be useful in the diagnosis of subclinical left and right ventricular dysfunction in hypertensive obese patients.
authors.affiliation: Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey. mktigen@yahoo.com
authors.forename: Mustafa Kürşat
authors.initials: MK
authors.lastname: Tigen
authors.forename: Tansu
authors.initials: T
authors.lastname: Karaahmet
authors.forename: Emre
authors.initials: E
authors.lastname: Gürel
authors.forename: Cihan
authors.initials: C
authors.lastname: Dündar
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.forename: Cihan
authors.initials: C
authors.lastname: Cevik
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akçakoyun
authors.forename: Yelda
authors.initials: Y
authors.lastname: Başaran
mesh_terms: D000054:Acceleration; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009765:Obesity / Q000150:complications*; D011237:Predictive Value of Tests; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055105:Waist Circumference