Isovolumic Acceleration in Predicting Preliminary Phase of Right and Left Ventricular Systolic Dysfunction in Hypertensive Obese Patients [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(1): 9-15

Isovolumic Acceleration in Predicting Preliminary Phase of Right and Left Ventricular Systolic Dysfunction in Hypertensive Obese Patients

Mustafa Kürşat Tigen1, Tansu Karaahmet1, Emre Gürel1, Cihan Dündar1, Selçuk Pala1, Cihan Çevik2, Mustafa Akçakoyun1, Yelda Başaran1
1Kartal Kosuyolu Heart Education And Research Hospital, Department Of Cardiology, Istanbul, Turkey
2Texas Tech University Health Sciences Center, Division of Internal Medicine, Lubbock, Tx, Usa

Aims: Isovolumic acceleration assessed with tissue Doppler imaging has been proposed as a preload-independent indicator of left ventricular contractility. We investigated the utility of isovolumic acceleration in the prediction of preclinical right and left ventricular systolic dysfunction in hypertensive and obese subjects.

METHODS
Seventy eight obese (body mass index>30 kg/m2) volunteers were prospectively enrolled. Conventional and tissue Doppler echocardiography was performed on all patients. Myocardial velocities of the left ventricular septal and lateral mitral annulus and lateral tricuspid annulus were obtained. The isovolumic contraction wave was determined as the preceding wave to the systolic wave that begins before the peak of the R wave on ECG. IVA was measured by dividing peak velocity by the time interval from onset of the wave (zero-crossing) during isovolumic contraction to the time at peak velocity of this wave.

RESULTS
There was a positive correlation between waist circumference and left ventricular end systolic (r=0.22 p=0.047) and end-diastolic diameter (r=0.384, r=0.001) and a negative correlation between waist circumference and tricuspid annulus TDI peak systolic velocity (r= -0.311, p=0.006). Although hypertensive and normotensive obese patients had similiar TDI based myocardial velocities, hypertensive obese patients had significantly lower tricuspid annulus isovolumic acceleration (p=0.027), septal isovolumic acceleration (p=0.026), and septal isovolumic contraction myocardial velocity (p=0.018) than normotensive obese subjects.

CONCLUSION
Isovolumic acceleration and isovolumic contraction myocardial velocity analysis may be useful in the diagnosis of subclinical left and right ventricular dysfunction in hypertensive and obese patients.

Keywords: Tissue Doppler echocardiography, obesity, isovolumic acceleration, hypertension

How to cite this article
Mustafa Kürşat Tigen, Tansu Karaahmet, Emre Gürel, Cihan Dündar, Selçuk Pala, Cihan Çevik, Mustafa Akçakoyun, Yelda Başaran. Isovolumic Acceleration in Predicting Preliminary Phase of Right and Left Ventricular Systolic Dysfunction in Hypertensive Obese Patients. Turk Kardiyol Dern Ars. 2011; 39(1): 9-15

Corresponding Author: Mustafa Kürşat Tigen, Türkiye
Manuscript Language: English
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