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Deceleration time of left ventricular outflow tract flow as a simple surrogate marker for central haemodynamics at rest and as well as during exercise

 In-Jeong Cho  ;  Chi Young Shim  ;  Sun-Ha Moon  ;  Hyun-Jin Lee  ;  Geu-Ru Hong  ;  Namsik Chung  ;  Jong-Won Ha 
 European Heart Journal-Cardiovascular Imaging, Vol.18(5) : 568-575, 2017 
Journal Title
 European Heart Journal-Cardiovascular Imaging 
Issue Date
Aged ; Biomarkers/analysis ; Blood Flow Velocity* ; Blood Pressure/physiology ; Cohort Studies ; Deceleration ; Echocardiography, Stress/methods* ; Female ; Heart Rate/physiology ; Hemodynamics/physiology* ; Humans ; Linear ; Models ; Male ; Middle Aged ; Pulse Wave Analysis/methods* ; Retrospective Studies ; Stroke Volume/physiology* ; Time Factors ; Ventricular Function, Left/physiology*
Doppler echocardiography ; arterial stiffness ; left ventricular outflow tract
Background: The shape and duration of left ventricular outflow tract (LVOT) flow has not been applied to assess the central haemodynamics, although LVOT flow is confronted with afterload of arterial system during systole. The aim of this study was to evaluate whether the LVOT flow parameters are related with central systolic blood pressure (BP) and arterial compliance at rest and as well as during exercise. Methods: We studied 258 subjects (175 females, age 61 ± 11 years) with normal left ventricular (LV) systolic function who underwent supine bicycle stress echocardiography and arterial tonometry simultaneously at rest and at peak exercise. Deceleration time (DT) of LVOT flow and RR interval were measured and deceleration time corrected for heart rate (DTc) was calculated. Peripheral and central haemodynamic parameters including systolic and diastolic BP, and augmentation index at a heart rate of 75 (AIx@75) were assessed using radial artery tonometry. Carotid femoral pulse wave velocity (PWV) was measured. Result: Deceleration time corrected for heart rate was independently associated with central systolic BP and AIx@75 at rest (P < 0.001 and 0.006). Similarly, it also showed significant independent correlations with central systolic BP and AIx@75 during peak exercise (P = 0.006 and P = 0.021). In addition, DTc which measured both at rest and at peak exercise demonstrated significant positive correlations with PWV, suggesting association of prolonged DTc with arterial stiffening (P = 0.023 and P = 0.005). Conclusion: Prolongation of LVOT flow DTc represents raised central systolic BP and increased arterial stiffness not only at rest but also during exercise. Therefore, central aortic pressures and arterial stiffness influence the DT of LVOT flow at rest as well as during exercise in individuals with normal LV systolic function.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
정남식(Chung, Nam Sik)
조인정(Cho, In Jeong)
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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