Abstract 3002: The Relationship between Left Ventricular Dyssynchrony and Diastolic Dysfunction in Hypertension
Background: Left ventricular (LV) dyssynchrony has been reported to play an important role in the advanced stage of heart failure (HF) which might be suitable for the cardiac resyncyronization therapy. However, the role of LV dyssynchrony has not been fully understood in the early stage of HF. The diastolic dysfunction influences the development of early staged HF and it is an important feature of hypertension. We investigated the relationship between LV dyssynchrony and diastolic dysfunction using dyssynchronous indices evaluated by ECG-gated SPECT (G-SPECT) and the indices of diastolic dysfunction by 2-D echocardiography.
Methods: We prospectively performed G-SPECT, tissue doppler imaging (TDI) and standard 2-D echocardiography simultaneously in consecutive 21 patients of hypertension with preserved systolic function (15 males; 65±3 years; EF 66.9±6.9%). Using a novel program “ cardioGRAF” by G-SPECT, we measured LV dyssynchrony of wall motion and wall thickening determined by indices which were the maximum differences among global 17 segments (MD). We recorded early diastolic velocity of mitral annulus (e’) as an index of diastolic function with TDI. We also measured early diastolic velocities of mitral peak flow (E) to determined E/e’ as an index of LV filling pressure and deceleration time (DT) of E with doppler echocardiography.
Results: In comparison with LV dyssynchrony of wall motion and echocardiographic indices of diastolic dysfunction, MD of Time to Peak Filling (MD-TPF) showed significant correlation with DT (r = 0.44, p < 0.05). MD of Time to Peak Ejection (MD-TPE) significantly correlated with e’ (r = −0.52, p<0.05) and E/e’ (r=0.69, p<0.01). Between LV dyssynchrony of wall thickening and diastolic indices of echocardiography, MD of Time to End wall Thickening (MD-TET) significantly correlated with DT (r=0.48, p<0.05).
Conclusion: A novel program “cardioGRAF” provided to detect mild diastolic abnormalities in patients with hypertension. It suggested that LV dyssynchrony of wall motion or wall thickening involved with the process of diastolic dysfunction.