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Left Ventricular Twist and Ventricular–Arterial Coupling in Hypertensive Patients

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Author(s)
Hong-Won ShinHyungseop KimJeong-Eun LeeIn-Cheol KimHyuck-Jun YoonHyoung-Seob ParkYun-Kyeong ChoChang-Wook NamSeung-Ho HurYoon-Nyun KimKwon-Bae Kim
Keimyung Author(s)
Kim, Hyung SeopKim, In CheolYoon, Hyuck JunPark, Hyoung SeobCho, Yun KyeongNam, Chang WookHur, Seung HoKim, Yoon NyunKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Echocardiography
Issued Date
2014
Volume
31
Issue
10
Abstract
Background: Left ventricular (LV) twist is usually influenced by LV hypertrophy resulting from hyp erten-
sion or vascular stiffness. Vascular stiffness would increase arterial elastance (Ea), whereas LV end-systolic
stiffness (Ees) could be influenced by LV hyp ertrophy. Therefore, in hypertensive patients, we assessed
the extent to which ventricular–arterial coupling (VAC; Ea/Ees) affects LV twist, which may be a com-
pensatory mechanism for systolic dysfunction. Methods: Hypertensive patients (n = 128) and healthy
controls (n = 40) underwent conven tional and speckle tracking echocardiography including LV twist.
Ea and Ees were estimated noninvasiv ely by echocardiography. Patients were divided into 3 tertiles
according to the twist angle. Univariate and mul tivariate regression analyses were perf ormed to test the
influence of VAC on twist. Results: Patients in the lowest LV twist tertile had larger LV end-systolic vol-
ume, lower ejection fraction, lesser mid-wall fractional shortening (MWFS), and higher LV mass index
(LVMI), compared to those with the highest tertile. They showed the lower septal tissue Doppler veloc-
ity, and global longitudinal and circumferential strain. With regard to VAC, Ea was simi lar among 3
groups, but Ees was significantly decreased in patient with lower tertile, resulting in increased VAC
(1.1  0.2 vs. 0.9  0.1 vs. 0.7  0.1, P < 0.001). While LV twist showed significant correlations with
Ees, MWFS, and LVMI, VAC (b = 14.92, P < 0.001) was most associated with twist in a multivariate
analysis. Conclusions: LV twist was significantly associated with VAC in acco rdance with LV function; LV
twist and VAC decreased progressively as LV systolic function deteriorated, while being enhanced dur-
ing the well-compensated phase. (Echocardiography 2014;31:1274–1282)
Key words: ventricular–arterial coupling, stiffness, elastance, echocardiography
Keimyung Author(s)(Kor)
김형섭
김인철
윤혁준
박형섭
조윤경
남창욱
허승호
김윤년
김권배
Publisher
School of Medicine
Citation
Hong-Won Shin et al. (2014). Left Ventricular Twist and Ventricular–Arterial
Coupling in Hypertensive Patients. Echocardiography, 31(10), 1274–1282. doi: 10.1111/echo.12561
Type
Article
ISSN
0742-2822
Source
http://lps3.onlinelibrary.wiley.com.proxy.dsmc.or.kr/doi/abs/10.1111/echo.12561
DOI
10.1111/echo.12561
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35609
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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