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

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.

内容要旨・審査要旨・論文本文の公開
本論文は, 著者Yuko Saitoの学位論文として提出され, 学位審査・授与の対象となっている。
著者の申請により要約(2019-06-06公開)に替えて論文全文を公開(2023-01-11)
This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use (https://www.springernature.com/gp/open-research/policies/accepted-manuscript-terms), but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s12574-019-00421-4