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Title: Disorders in the left ventricular function and perfusion assessed by tissue Doppler echocardiography and cardiovascular magnetic resonance in hypertension

Abstract:

Arterial hypertension can influence on diastolic function and coronary microcirculation. The aim of the study was to assess left ventricular systolic and diastolic function in patients with hypertension at rest and during dobutamine stress test and to assess myocardial perfusion by CMR at rest and after an infusion of adenosine. The study group included 85 persons (mean age 56,7 ± 7,0 years, 61 (72%) woman and 24 (28%) men) with arterial hypertension and normal picture of coronary arteries in coronarography. By all patients we performed echocardiographic examination at rest and during dobutamine stress test. By 80 of them we assessed myocardial perfusion by CMR. Resylts: By 41 (47%) patients at least 1 parameter of mitral inflow was pathologic and most frequently we observed prolongated deceleration time (by 35 (41%) pts. ). We observed higher systolic and diastolic velocieties for lateral mitral annulus than for septal annulus. During an infusion of the low dose of dobutamine we observed increase of systolic and early- and late- diastolic velocities for lateral and the septal mitral annulus. During an infusion of maximal dose of dobutamine we observed further increase of the systolic and late diastolic velocities. We observed no increase of the early diastolic velocity for lateral annulus an even little decrease of the early diastolic velocity of the septal annulus. This results were independent of gender, MPRI nor the presence of left ventricular hypertrophy except for early diastolic velocity for septal annulus during maximal dose of dobutamine (M IVS E), which was significantly lower in patients with LVH an low MPRI. We observed positive correlation of M IVS E with E/A and the negative correlation of M IVS E with DT and IVRT. In CMR we observed increase of MPI after an infusion of adenosine. The mean value of the quantified myocardial perfusion reserve index (MPRI) was 1,84. value of MPRI < 2, which we accounted as a diminished was observed by 59 (74%) patients. We observed no correlation of MPRI with gender, presence of LVH type of left ventricular remodeling and diastolic dysfunction assessed by classical parameters. By 24 (28%) patients during maximal dose of dobutamine we observed intraventricular obstruction . Conclusions: In the examined group of patients with arterial hypertension in 47% we observed prolongated relaxation. Systolic function was normal. We observed little decrease of early diastolic velocity of septal mitral annulus during maximal dose of dobutamine. This finding suggests that IVS is involved in the early process of left ventricular diastolic dysfunction in patients with arterial hypertension. The facts that patients with LVH and diminished MPRI had even lower values of early diastolic velocity of septal mitral annulus during maximal dose of dobutamine (M IVS E) suggests the influence of LVH an disorders in coronary microcirculation on diastolic dysfunction.

Level of degree:

2 - studia doktoranckie

Degree discipline:

choroby układu krążenia

Degree grantor:

Wydział Lekarski

Promoter:

Danuta Czarnecka

Date issued:

2007

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:971

Call number:

ZB-107303

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Feb 12, 2020

In our library since:

Nov 21, 2012

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All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/971

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ZB-107303 Feb 12, 2020
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