title: Correlation between systolic deformation and dyssynchrony indices and the grade of left ventricular hypertrophy in hypertensive patients with a preserved systolic ejection fraction undergoing coronary angiography, based on tissue Doppler imaging.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether systolic mechanical dyssynchrony occurs in hypertensive patients with a normal coronary artery and a normal ejection fraction and its relationship with different degrees of left ventricular (LV) hypertrophy.
  
  
  METHODS
  A total of 125 angiographically normal coronary patients (42.4% male; mean age ± SD, 57.16 ± 8.26 years) with an ejection fraction greater than 50% were included, of which 84 were hypertensive and 41 normotensive. The hypertensive patients were categorized into 3 groups: no, mild, and moderate LV hypertrophy. Tissue Doppler and deformation imaging parameters were measured in the 6 LV basal segments at peak systole.
  
  
  RESULTS
  The frequency of dyssynchrony was 40.5% in the hypertensive patients compared to 19.5% in the control patients (P = .020). Among the hypertensive patients, LV dyssynchrony was found in 5 patients (20%) with no hypertrophy, 20 (42.6%) with mild hypertrophy, and 9 (75%) with moderate hypertrophy. There was a moderate correlation between the grade of hypertrophy and septal-lateral wall delay (r = 0.497), 6-basal segment delay (r = 0.454), overall strain (r = 0.453), overall peak systolic velocity (r = -0.430), and standard deviation of the time to peak systolic velocity in the basal segments (r = 0.429). After adjustment for the LV end-systolic diameter and body surface area, overall strain was the best correlate of the hypertrophy grade (odds ratio, 7.043; 95% confidence interval, 1.839-26.980; P = .0044).
  
  
  CONCLUSIONS
  Among tissue Doppler and deformation indices, overall peak systolic strain was the strongest correlate of the LV hypertrophy grade. Therefore, in hypertensive patients with normal cardiac systolic function, a reduction in overall strain in the 6 basal LV segments may be a good indicator of progression of the LV hypertrophy grade and systolic dysfunction.
authors.affiliation: Department of Echocardiography, Tehran Heart Center, North Kargar Street, Tehran 14117 13138, Iran. roomiz@sums.ac.ir.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Zoroufian
authors.forename: Tannaz
authors.initials: T
authors.lastname: Razmi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Savandroomi
authors.forename: Masoumeh Lotfi
authors.initials: ML
authors.lastname: Tokaldany
authors.forename: Hakimeh
authors.initials: H
authors.lastname: Sadeghian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sahebjam
authors.forename: Arash
authors.initials: A
authors.lastname: Jalali
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D004452:Echocardiography / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis*
keywords: hypertension; left ventricular hypertrophy; strain imaging; synchronicity; tissue Doppler imaging; vascular ultrasound