title: Early diastolic dyssynchrony in relation to left ventricular remodeling and function in hypertension.
abstract: BACKGROUND
  Cardiac synchronization is important in maintaining myocardial performance, but the mechanism of diastolic dyssynchrony leading to failing myocardium is unclear. We aim to study the relation of left ventricular (LV) diastolic dyssynchrony with diastolic dysfunction in patients with hypertension.
  
  
  METHODS
  Two-D, three-D and Doppler echocardiography were performed using the GE Vivid E9 system on 230 subjects. Among them, 154 patients with hypertension were divided into group 1 (86 patients with mild to moderate hypertension, BP 152 ± 8/91 ± 11 mm Hg) and group 2 (68 patients with severe hypertension, BP 188 ± 12/105 ± 24 mm Hg), age 76, gender matched normotensive subjects (119 ± 6/76 ± 9 mm Hg) as control. The routine 2D and Doppler parameters were measured and LV systolic and diastolic dyssynchrony indices were determined as the standard deviation of the time interval from the peak R of the QRS complex to peak myocardial systolic strain rate (Ts-SD), and to early diastolic strain rate (Te-SD) of 12 LV segments.
  
  
  RESULTS
  LV relative wall thickness, mass index, and Te-SD were significantly higher in patients with hypertension than in control group (p<0.0001), but Ts-SD showed no significant differences. Te-SD and diastolic dysfunction worsened progressively with increasing severity of hypertension (p<0.05). Te-SD was significantly and independently associated with parameters of LV remodeling and diastolic function.
  
  
  CONCLUSIONS
  Our study demonstrated that LV diastolic dyssynchrony was associated with LV remodeling, which seems to contribute to diastolic dysfunction in hypertension. This diastolic dyssynchrony index derived from speckle tracking echocardiography can be used as a marker for studying the LV function and effects of therapy in hypertensive heart disease.
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Jing Ping
authors.initials: JP
authors.lastname: Sun
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ting-Yan
authors.initials: TY
authors.lastname: Xu
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Alex Pui-Wai
authors.initials: AP
authors.lastname: Lee
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Xing Sheng
authors.initials: XS
authors.lastname: Yang
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
authors.affiliation: Division of Cardiology, S.H. Ho Cardiovascular and Stroke Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China. Electronic address: cmyu@cuhk.edu.hk.
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020257:Ventricular Remodeling / Q000502:physiology
keywords: Diastolic function; Hypertension; Speckle tracking imaging