title: Impact of antihypertensive treatment on left ventricular systolic dyssynchrony in treatment-naïve hypertensive patients.
abstract: Dyssynchrony is common in asymptomatic patients with hypertension. We sought to investigate the impact of antihypertensive treatment on dyssynchrony in patients with hypertension. A total of sixty patients who had uncomplicated hypertension that had never been treated (treatment-naïve hypertensive patients) underwent echocardiographic evaluations of left ventricular (LV) dyssynchrony at baseline and after a 6-month treatment with antihypertensive drugs. The measured parameters were as follows: (1) the s.d. of 12 LV-segment time-to-peak systolic velocities (Ts-SD12), and (2) the maximal difference between peak systolic velocities of any 2 of the 12 segments (Ts-Max). Patients with Ts-SD12 ≥ 33 ms or Ts-Max ≥ 100 ms were regarded as having LV systolic dyssynchrony. Patients with systolic dyssynchrony (group 1, n = 29) and without systolic dyssynchrony (group 2, n = 31) were compared. Among the patients in group 1, antihypertensive treatment significantly improved LV systolic dyssynchrony (ΔTs-SD12, -13.1 ms; P<0.001 and ΔTs-Max, -34.0 ms; P = 0.003), whereas it did not demonstrate additional benefit among group 2 patients. The change in LV systolic dyssynchrony was significantly associated with changes in the mean annulus E' velocity, mean annulus S' velocity and mean annulus E'/A' ratio, but not with changes in blood pressure and LV mass index. It is likely that chronic antihypertensive treatment could reverse the LV systolic dyssynchrony and simultaneously improve subclinical systolic and diastolic function in patients with hypertension and LV systolic dyssynchrony.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul's Hospital, Seoul, Republic of Korea.
authors.forename: Beom-June
authors.initials: BJ
authors.lastname: Kwon
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Jang
authors.forename: Kyu-Young
authors.initials: KY
authors.lastname: Choi
authors.forename: Dong-Bin
authors.initials: DB
authors.lastname: Kim
authors.forename: Eun-Joo
authors.initials: EJ
authors.lastname: Cho
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Ihm
authors.forename: Ho-Joong
authors.initials: HJ
authors.lastname: Youn
authors.forename: Tai-Ho
authors.initials: TH
authors.lastname: Rho
authors.forename: Jae-Hyung
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology*; D001794:Blood Pressure / Q000187:drug effects; D015897:Comorbidity; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D004232:Diuretics