title: The impact of hypertension as a road to heart failure with preserved ejection fraction: diagnostic value of two-dimensional speckle tracking echocardiography for the early impairment of left atrial-left ventricular-arterial coupling.
abstract: Heart failure with preserved ejection fraction (HFPEF) is a syndrome that frequently occurs in older people and patients with cardiovascular risk factors, particularly hypertension. This syndrome is not a specific disease process, whereas is associated with high morbidity and mortality in patients with heart failure with reduced ejection fraction (HFREF) as well. Therefore, a "one size fits all" diagnosis strategy is unlikely to operate for patients with HFPEF. Assessment of left atrial (LA)-left ventricular (LV)-arterial coupling seems to have a clinical impact on hypertensive patients, because HF signs and symptoms have been found to be significantly related to inappropriate LA-LV interaction during diastole and LV-arterial interaction during systole. Two-dimensional speckle tracking echocardiography (2DSTE) is a new tool that may have a role in earlier detecting the impaired LA, LV, and arterial function in asymptomatic patients. This review explored the impact of LA-LV-arterial coupling in understanding the pathophysiology of hypertension as a road to HFPEF, and the possibilities of clinical application by using 2DSTE.
authors.affiliation: Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, 1-1 Ohmukaikita, Ohtera, Itano, Itano, Tokushima 779-0193, Japan. oki@higasitokusima.hosp.go.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
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: Nusrat
authors.initials: N
authors.lastname: Ara
authors.forename: Arata
authors.initials: A
authors.lastname: Iuchi
mesh_terms: D004452:Echocardiography / Q000379:methods*; D006325:Heart Atria / Q000503:physiopathology*; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology