title: Influence of comorbid cardiovascular risk factors on left atrial-left ventricular interaction in asymptomatic patients: clinical application of two-dimensional speckle-tracking echocardiography.
abstract: Previous studies have examined the negative impacts of individual cardiovascular risk (CVR) factors on left atrial (LA)-left ventricular (LV) interaction, whereas the combined effects of these risk factors are insufficiently elucidated. We studied 176 asymptomatic patients with CVR factors and age-matched 50 healthy individuals by conventional and 2-dimensional speckle-tracking echocardiography. The patients were classified into 2 groups according to the number of CVR factors: one risk factor (single) group (n = 79) and 2 or more risk factors (comorbid) group (n = 97). The peak early diastolic transmitral flow velocity (E)/peak early diastolic mitral annular motion velocity (e')/peak systolic LA strain (S-LAs) was used as a surrogate for LA stiffness during ventricular systole. The E/e'/S-LAs was greatest in the comorbid group. The peak systolic LV circumferential and radial strains, peak early diastolic LV radial strain rate, and peak early diastolic LA strain and strain rate were lower in the comorbid group than in the single group. Multivariate regression analysis identified age, body mass index, systolic blood pressure, end-systolic LV diameter, peak systolic mitral annular motion velocity (s'), and peak systolic LV radial strain in the comorbid group, and peak atrial systolic transmitral fl ow velocity and s' in the single group, as independent predictors of E/e'/S-LAs. Subtle LA and LV dysfunction with individual CVR factors were more aggravated with the comorbid conditions in asymptomatic patients.
authors.affiliation: Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Oishi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Arata
authors.initials: A
authors.lastname: Iuchi
authors.forename: Norio
authors.initials: N
authors.lastname: Nagase
authors.forename: Nusrat
authors.initials: N
authors.lastname: Ara
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016279:Atrial Function, Left / Q000502:physiology*; D059168:Carotid Intima-Media Thickness; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000008:administration & dosage; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage; D012307:Risk Factors; D000068718:Rosuvastatin Calcium; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000008:administration & dosage; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D017035:Pravastatin