Abstract 12262: Post-systolic Strain Index Was Associated With Diastolic Dysfunction Through the Effect of Delayed Diastolic Lengthening of Left Ventricle In Hypertension
Introduction: Post-systolic shortening is associated with hypertensive heart disease and degree of post-systolic shortening can be measured by post-systolic strain index (PSI) of left ventricular (LV) derived from speckle tracking echocardiography.
Hypothesis: PSI contributed to diastolic dysfunction (DD) through the effect of delayed diastolic lengthening in hypertension.
Methods: This study recruited 46 patients (mean age 56 ± 13 years, 24 men) with untreated hypertension and 26 age- and sex-matched normal subjects as control. Hypertension subjects were further divided into 2 groups based on presence of DD. Two-dimensional speckle tracking echocardiography with automatic functional imaging was used for measurement of PSI. PSI was calculated as [(post-systolic peak longitudinal strain — end-systolic strain)/end-systolic strain] × 100%. Timing of LV diastolic lengthening was determined by measurements of time to onset of mitral annulus early diastolic lengthening by tissue Doppler imaging.
Results: Left ventricular mass index and left atrial volume index were higher in hypertension, but there were no difference between patients with or without DD. PSI was significantly higher in patients with DD (252 ± 257 vs. 98 ± 72%, p = 0.002). After multivariate analysis, PSI was independently associated with DD in hypertension (every 10% increment of PSI, OR 1.13, 95%CI 1.01–1.27, p = 0.036). PSI was independently correlated with serum procollagen type I carboxyterminal propeptide (Beta = 0.382, p = 0.028) after multivariate analysis. PSI was independently correlated with time delay from onset of early mitral inflow to onset of medial (Beta = 0.389, p = 0.004) or lateral (Beta = 0.561, p <0.001) annulus early diastolic lengthening.
Conclusions: Increased PSI was associated with increased myocardial fibrosis and contributed to DD in hypertension. Post-systolic shortening caused delayed diastolic lengthening contributed to DD in hypertension.
- © 2010 by American Heart Association, Inc.