J Korean Soc Echocardiogr.  1996 Jul;4(1):57-65. 10.4250/jkse.1996.4.1.57.

Left Ventricular Systolic Function Indexes by Echocardiography in Hypertensive Subjects

• Sohn SS
• Kim SH
• Jeong JW
• Park YK
• Park OK

• KMID: 2410406
• DOI: http://doi.org/10.4250/jkse.1996.4.1.57

Abstract

BACKGROUND
The evaluation of cardiac performance is very important to management and prognostication in hypertensive patients. Although ejection phase indexes have been used for assessing left ventricular systolic function they are highly dependent on cardiac loading conditions. In addition, these load-dependent indexes may not differentiate accurately between the effects of altered loading canditions and intrinsic abnormalities in contractile function of cardiac muscle. In recent years, the end-systolic pressure to volume of dimension relations have emerged as a reliable measure of the myocardial contractility. The authors studied the changes of end-systolic pressure to volume or dimension relations according to pre-load and after-load by using the Echocardiogram.
METHODS
By 2-D and M-mode Echocardiogram we measured the ratio of end-systolic wall stress to end-systolic volume index(EWS/ESVI), peak systolic pressure or end-systolic dimension of left ventricle(PSP/ESD), peak systolic pressure to end-systolic volume index(PSP/ESVI) to assess myocardial contractility in 139 normal subjects and 55 patients with untreated essential hypertension. Then we compare these indexes to systemic blood pressure & left ventriclular end-diasolic dimension.
RESULTS
1) EF, %FS, and mVcf were similar in both groups, but PSP/ESD, PSP/ESVI, EWS/ESVI for the hypertensive group were greater than that for the normal group. 2) There was poor relation between arterial blood pressure and EWS/ESVI than oter load independent indexes in both groups. 3) There was poor reation between left ventricle end diastolic dimension than oter load independent indexes in both groups.
CONCLUSION
The ratio of end-systolic wall stress to end-systolic volume index(EWS/ESVI) is a relible load independent index to assess myocardial contractility in hypertension.

Keyword

Myocardial contractility; Load independent index

MeSH Terms

Arterial Pressure
Blood Pressure
Echocardiography*
Heart Ventricles
Humans
Hypertension
Myocardium

Figure

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  Fig. 1. Relations of SBP to (A) PSP/ESD (r=0.65) (B) PSP/ESVI (r=0.41), (C) EWS/ESVI (r=0.17) in normal subjects. SBP: Systolic blood pressure PSP: Peak systolic blood pressure ESD: Left ventricular end-systolic dimension ESVI: Left ventricular end systolic volume index EWS: Left ventricle end systolic wall stress.

• 

  Fig. 2. Relations of SBP to (A) PSP/ESD (r=0.32) (B) PSP/ESVI (r=0.06), (C) EWS/ESVI (r=0.002) in hypertensive subjects. SBP: Systolic blood pressure PSP: Peak systolic blood pressure ESD: Left ventricular end-systolic dimension ESVI: Left ventricular end systolic volume index EWS: Left ventricle end systolic wall stress.

• 

  Fig. 3. Relations of EDD to (A) PSP/ESD (r=–0.55) (B) PSP/ESVI (r=0.56), (C) EWS/ESVI (r=–0.40) in normal subjects. EDD: Left ventricular end-diastolic dimension, PSP: Peak systolic blood pressure ESD: Left ventricular end-systolic dimension ESVI: Left ventricular end systolic volume index EWS: Left ventricle end systolic wall stress.

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  Fig. 4. Relations of EDD to (A) PSP/ESD (r= −0.657) (B) PSP/ESVI (r=–0.68), (C) EWS/ESVI (r=–0.30) in hypertensive subjects. EDD: Left ventricular end-diastolic dimension, PSP: Peak systolic blood pressure ESD: Left ventricular end-systolic dimension ESVI: Left ventricular end systolic volume index EWS: Left ventricle end systolic wall stress.

Reference

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