Noninvasive assessment of left-ventricular diastolic electromechanical coupling in hypertensive heart disease

• Material Type: 博士論文
• Title: Noninvasive assessment of left-ventricular diastolic electromechanical coupling in hypertensive heart disease
• Author/Editor: Saito, Yuko; Yamada, Hirotsugu; Kusunose, Kenya; Saito, Ken; Sata, Masataka
• Author Heading: Saito, Yuko; Yamada, Hirotsugu; Kusunose, Kenya; Saito, Ken; Sata, Masataka
• Publication, Distribution, etc.: Japanese Society of Echocardiography|Springer nature
• Publication Date: 2019-02-12
• Publication Date (W3CDTF): 2019-02-12
• Alternative Title: 高血圧性心疾患における左室拡張期電気機械的カップリングの非侵襲的評価法; Electromechanical Coupling in HHD
• Degree grantor/type: 徳島大学
• Date Granted: 2019-03-19
• Date Granted (W3CDTF): 2019-03-19
• Dissertation Number: 甲第3266号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Tpeak-Tend interval; E/e'; hypertension; diastolic electromechanical coupling
• Target Audience: 一般
• Note (General): Background: There is a need to stratify patients who may develop heart failure because of the current “heart failure pandemic”. We hypothesized that noninvasive assessment of diastolic electromechanical coupling by electrocardiography and Doppler echocardiography may be clinically useful for risk stratification of hypertensive patients who may develop heart failure.Methods: We measured the time from the peak to end of the T-wave (TpTe) as an electrophysiological parameter, and peak early-diastolic mitral flow (E) and lateral annular (e’) velocities as mechanical parameters in 109 patients with hypertension. Relationships between these parameters and their association with the prognosis was evaluated.Results: The e’ was inversely correlated with TpTe (p<0.001) and QTc (p < 0.014), whereas E/e’ was positively correlated with TpTe (p<0.001) and QTc (p<0.001). The TpTe predicted patients with E/e’ > 12. There were 24 cardiovascular events during follow-up (57 ± 20 months), and Kaplan-Meir analysis showed that outcome was worse (p=0.003) in patients with higher E/e’ than lower E/e’, however, there was no difference between patients with longer TpTe (≧72 msec) and shorter TpTe (<72 msec).Conclusions: The correlation of TpTe with e’ and E/e’ in hypertensive patients suggests that these parameters reflect diastolic ventricular electromechanical coupling. The E/e’ predicted outcome, and an elevated E/e’ should be suspected when TpTe is prolonged (> 72 msec). Noninvasive evaluation of diastolic electromechanical coupling is clinically useful in patients with hypertension.
• Persistent ID (NDL): info:ndljp/pid/12661718; https://dl.ndl.go.jp/pid/12661718
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• Date Accepted (W3CDTF): 2023-03-03T17:22:18+09:00
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• Periodical Title (URI): http://repo.lib.tokushima-u.ac.jp/113350
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