Optimal Blood Pressure Control Improves Left Ventricular Torsional Deformation and Vascular Function in Newly Diagnosed
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ORIGINAL ARTICLE
Optimal Blood Pressure Control Improves Left Ventricular Torsional Deformation and Vascular Function in Newly Diagnosed Hypertensives: a 3-Year Follow-up Study Stavros Tzortzis 1 & Ignatios Ikonomidis 1 & Hellen Triantafyllidi 1 & Paraskevi Trivilou 1 & George Pavlidis 1 & Spyridon Katsanos 1 & Konstantinos Katogiannis 1 & Dionisia Birba 1 & John Thymis 1 & Georgios Makavos 1 & Maria Varoudi 1 & Alexandra Frogoudaki 1 & Agathi-Rosa Vrettou 1 & Dimitrios Vlastos 1 & John Parissis 1 & John Lekakis 1 Received: 23 July 2019 / Accepted: 20 December 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract We investigated the effects of optimizing blood pressure control on cardiac deformation and vascular function. For this purpose, in 200 untreated patients with essential hypertension, we assessed at baseline as well as after 3 years of optimal blood pressure control: arterial stiffness and coronary microcirculatory function as well as longitudinal and torsional deformation parameters. Compared to baseline, after 3 years of optimal blood pressure control, there was an improvement of longitudinal strain, twisting as well as untwisting parameters of the left ventricle. In parallel, there was an improvement in coronary microcirculatory function, arterial stiffness, left ventricular mass, and ventricular-arterial interaction. The reduction of arterial stiffness was independently associated with the respective improvement of cardiac deformation markers and coronary flow reserve after adjusting for blood pressure improvement. Blood pressure optimization improves LV longitudinal and torsional mechanics in hypertensives in parallel with arterial stiffness, resulting in improved ventricular-arterial interaction and coronary flow reserve. Trial registration: ClinicalTrials.gov Identifier: NCT02346695 Keywords Arterial stiffness . Pulse wave velocity . Coronary flow reserve . LV diastolic dysfunction . LV twisting and untwisting
Abbreviations PWV Pulse wave velocity CFR Coronary flow reserve pTw Peak twisting pTwVel Peak twisting velocity pUtwVel Peak untwisting velocity Stavros Tzortzis and Ignatios Ikonomidis contributed equally to this work. Associate Editor Ana Barac oversaw the review of this article * Ignatios Ikonomidis [email protected] 1
Department of Echocardiography and Laboratory of Preventive Cardiology, 2nd Cardiology Department, Attikon Hospital, National and Kapodistrian University of Athens, Rimini 1, Haidari, 12462 Athens, Greece
UtwMVO UtwPEF UtwEDF
Untwisting at mitral valve opening. Untwisting at peak of early LV diastolic filling Untwisting at end of early LV diastolic filling
Introduction Increased arterial stiffness, as assessed by pulse wave velocity (PWV) [1], as well as impaired coronary flow reserve (CFR) has been linked to left ventricular (LV) diastolic dysfunction [2, 3], abnormal LV longitudinal deformation, and LV twisting-untwisting as assessed by two-dimensional speckle tracking imaging in hypertensive heart disease [4]. Antihypertensive treatment h
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