Korean Journal of Pediatrics 2010;53(1):72-79.
Published online January 15, 2010.
Left ventricular dysfunction measured by tissue Doppler imaging and strain rate imaging in hypertensive adolescents
Hye Mi Ahn, Sun Ok Jung, Jung Hyun Kwon, Young Mi Hong
Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
고혈압 청소년에서 tissue Doppler imaging과 strain rate imaging을 이용한 좌심실 기능 이상에 대한 연구
안혜미, 정선옥, 권정현, 홍영미
이화여자대학교 의학전문대학원 소아과학교실
Correspondence: 
Young Mi Hong, Tel: +82-2-2650-2841, Fax: +82-2-2653-3718, Email: ymhong@ewha.ac.kr
Abstract
Purpose
: Left ventricular (LV) hypertrophy and impaired diastolic function may occur early in systemic hypertension. Diastolic dysfunction is associated with increased cardiovascular risk. Tissue Doppler imaging (TDI)-derived tissue velocity and strain rate are new parameters for assessing diastolic dysfunction. The aim of this study is to determine whether TDI and strain rate imaging (SRI) would improve the ability to recognize early impaired diastolic and systolic functions compared with conventional echocardiography in hypertensive adolescents.
Methods
: We included 38 hypertensive patients with systolic blood pressure above 140 mmHg or diastolic blood pressure above 90 mmHg. Ejection fraction and myocardial performance index (MPI) were estimated by conventional echocardiography. Peak systolic myocardial velocity, early diastolic myocardial velocity (Em), and peak late diastolic myocardial velocity (Am) were obtained by using TDI and SRI.
Results
: In the hypertensive group, interventricular septal thickness was significantly increased on M-mode echocardiography. Em/Am was significantly decreased at the mitral valve annulus. Among hypertensive subjects, the E strain rate at basal, mid, and apex was significantly decreased. Systolic strain was significantly decreased at the septum in the hypertensive group.
Conclusion
: Strain rate might be a useful new parameter for the quantification of both regional and global LV functions and could be used in long-term follow up in hypertensive patients. Early identification by SRI of subjects at risk for hypertensive and ventricular dysfunction may help to stratify risk and guide therapy. Further studies, including serial assessment of LV structure and function in a larger number of adolescents with hypertension, is necessary.
Key Words: Hypertension, Ventricular dysfunction, Adolescent


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