title: Mitral annular systolic velocity as a marker of preclinical systolic dysfunction among patients with arterial hypertension.
abstract: BACKGROUND
  The aim of this study was to investigate early changes in left ventricular longitudinal systolic function in patients with hypertension (HTN) with and without concomitant diastolic dysfunction (DD) and the clinical implications of these findings.
  
  
  METHODS
  We enrolled 299 patients with HTN and 297 age-matched patients with HTN and DD and compared both groups with an age-matched control group consisting of 100 healthy subjects. The long axis systolic function was investigated by determining the average peak systolic velocity of the septal and lateral mitral sites (Sm avg) using spectral pulsed wave tissue Doppler imaging (TDI).
  
  
  RESULTS
  We found a strong negative trend toward the reduction of velocity, which is dependent on the grade of HTN, on the magnitude of DD, and also on the gender and age of the subjects (r=-0.891/-0.580; p<0.0001). The data showed that the beginning and evolution of HTN are related to a slight but significant reduction in the long axis systolic function (10.2-10.0 cm/s; p<0.0001), and DD worsens this initial finding (9.8-8.8 cm/s; p<0.0001).
  
  
  CONCLUSIONS
  The strength of the study is the analysis of incremental changes in longitudinal contraction in patients with different stage of HTN but not so many the classification of the degree of systolic dysfunction. The importance of our results lies in the fact that these initial changes in systolic contraction could be used as an early sign that should prompt optimization of the treatment of HTN.
authors.affiliation: Department of Cardiology and Intensive Care, Cardiology Clinic, Military Medical Academy, 3 Georgi Sofiiski Blvd., Sofia, 1606, Bulgaria. ivodaskalov@mail.bg
authors.forename: Ivaylo Rilkov
authors.initials: IR
authors.lastname: Daskalov
authors.forename: Plamen Dimitrov
authors.initials: PD
authors.lastname: Petrovsky
authors.forename: Lilia Davidkova
authors.initials: LD
authors.lastname: Demirevska
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D012307:Risk Factors; D012737:Sex Factors; D013599:Systole / Q000502:physiology; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult