title: Association between Left Ventricular Postsystolic Shortening and Diastolic Relaxation in Asymptomatic Patients with Systemic Hypertension.
abstract: BACKGROUND
  Few data have existed on myocardial postsystolic shortening (PSS) accounting for left ventricular (LV) diastolic dysfunction in systemic hypertension. We examined this relationship, along with clinical and other cardiac parameters, in asymptomatic patients with hypertension.
  
  
  METHODS
  We analyzed 104 patients on pharmacological treatment for hypertension who had no signs or symptoms of heart failure for conventional and speckle tracking echocardiography. The sum of the postsystolic index for multiple LV segments (total PSI) and global longitudinal strain (GLS) was computed and used as measures for global PSS and myocardial systolic function, respectively. The tissue Doppler e' and the speckle tracking-derived global strain rate during early diastole (e'sr) were obtained as indicators of LV relaxation. The circumferential end-systolic stress was also determined noninvasively and substituted for a measure of myocardial afterload.
  
  
  RESULTS
  Main variables that correlated with the e' and e'sr were shown to be age, LV mass index, left atrial volume index, GLS, and the total PSI. Multivariate analysis including gender, circumferential end-systolic stress, and the use of calcium channel blockers as possible covariates revealed that age (β = -0.29, P = 0.002), total PSI (β = -0.26, P = 0.008), and LV mass index (β = -0.25, P = 0.017) were significant independent determinants of e' and that age (β = -0.34, P < 0.001) and GLS (β = -0.28, P = 0.006) were of e'sr.
  
  
  CONCLUSIONS
  Our findings indicate that while depending on the degree of GLS, PSS may affect diastolic relaxation in patients with asymptomatic, but treated, hypertensive patients.
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Nogi
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Takahide
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kizawa
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Shimamoto
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sohmiya
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hoshiga
authors.affiliation: Department of Cardiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: diastolic function; hypertension; myocardial function; postsystolic shortening; speckle tracking