Impaired Left Ventricular Systolic Synchronicity in Hypertensive Patients with Ventricular Arrhythmias

Abstract

Left ventricular (LV) systolic synchronicity is impaired in hypertensive patients. Ventricular arrhythmias often co-exist in hypertensive patients; hypertension and ventricular arrhythmias have an adverse impact on cardiac function. However, the influence of ventricular arrhythmias on LV synchronicity was not clear. The objective of the present study was to investigate the influence of ventricular arrhythmias on LV synchronicity in hypertensive patients. Tissue Doppler imaging (TDI) was performed in 136 subjects. Group 1 consisted of 74 hypertensives without any arrhythmias; group 2 consisted of 30 hypertensive patients with ventricular arrhythmias; and the control group consisted of 32 normal subjects. Using three apical views, LV synchronicity was assessed by the maximal differences in time to peak myocardial systolic contraction (T(s)) and early diastolic relaxation (T(e)) between any two of the LV segments (T(s)-max, T(e)-max) and the standard deviation of T(s) (T(s)-SD) and T(e) (T(e)-SD) of all 12 segments. T(s)-max was significantly prolonged in group 2 compared with group 1 and the control group (93.70 +/- 20.97 ms vs. 79.48 +/- 25.46 ms [p<0.01] or 53.83 +/- 15.42 ms [p<0.001], respectively). T(s)-SD was also significantly prolonged in group 2 compared with group 1 and the control group (38.16 +/- 5.82 ms vs. 33.37 +/- 6.04 ms [p<0.05] or 24.01 +/- 3.58 ms [p<0.001], respectively). In conclusion, LV systolic synchronicity was impaired in hypertensive patients with ventricular arrhythmias, and TDI was shown to be useful for the detection of myocardial abnormalities in such patients.