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Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension

BACKGROUND: The use of impedance cardiography (ICG) may play a role in the assessment of cardiac effects of hypertension (HT), especially its hemodynamic features. Hypertensive heart disease involves structural changes and alterations in left ventricular geometry that end up causing systolic and/or...

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Autores principales: Nazário Leão, Rodrigo, Marques Silva, Pedro, Branco, Luísa, Fonseca, Helena, Bento, Bruno, Alves, Marta, Virella, Daniel, Palma Reis, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5744395/
https://www.ncbi.nlm.nih.gov/pubmed/29299336
http://dx.doi.org/10.1186/s40885-017-0084-y
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author Nazário Leão, Rodrigo
Marques Silva, Pedro
Branco, Luísa
Fonseca, Helena
Bento, Bruno
Alves, Marta
Virella, Daniel
Palma Reis, Roberto
author_facet Nazário Leão, Rodrigo
Marques Silva, Pedro
Branco, Luísa
Fonseca, Helena
Bento, Bruno
Alves, Marta
Virella, Daniel
Palma Reis, Roberto
author_sort Nazário Leão, Rodrigo
collection PubMed
description BACKGROUND: The use of impedance cardiography (ICG) may play a role in the assessment of cardiac effects of hypertension (HT), especially its hemodynamic features. Hypertensive heart disease involves structural changes and alterations in left ventricular geometry that end up causing systolic and/or diastolic dysfunction. The IMPEDDANS study aims to assess the usefulness of ICG for the screening of left ventricular diastolic dysfunction (LVDD) in patients with HT. METHODS: Patients with HT were assessed by echocardiography and ICG. Receiver-operating characteristic curve and the area under the curve were used to assess the discriminative ability of the parameters obtained by ICG to identify LVDD, as diagnosed by echocardiography. RESULTS: ICG derived pre-ejection period (PEP), left ventricle ejection time (LVET), systolic time ratio (STR) and D wave were associated (p < 0.001) with LVDD diagnosis, with good discriminative ability: PEP (AUC 0.81; 95% CI 0.74–0.89), LVET (AUC 0.82; 95% CI 0.75–0.88), STR (AUC 0.97; 95% CI 0.94–1.00) and presence of D wave (AUC = 0.87; 95% CI 0.82–0.93). STR ≥ 0.30 outperformed the other parameters (sensitivity of 98.0%, specificity of 90.2%, positive predictive value of 95.2%, and negative predictive value of 96.1%). CONCLUSION: The ICG derived value of STR allows the accurate screening of LVDD in patients with HT. It might as well be used for follow up assessment. TRIAL REGISTRATION: The study protocol was retrospectively registered as IMPEDDANS on ClinicalTrials.gov (ID: NCT03209141) on July 6, 2017.
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spelling pubmed-57443952018-01-03 Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension Nazário Leão, Rodrigo Marques Silva, Pedro Branco, Luísa Fonseca, Helena Bento, Bruno Alves, Marta Virella, Daniel Palma Reis, Roberto Clin Hypertens Research BACKGROUND: The use of impedance cardiography (ICG) may play a role in the assessment of cardiac effects of hypertension (HT), especially its hemodynamic features. Hypertensive heart disease involves structural changes and alterations in left ventricular geometry that end up causing systolic and/or diastolic dysfunction. The IMPEDDANS study aims to assess the usefulness of ICG for the screening of left ventricular diastolic dysfunction (LVDD) in patients with HT. METHODS: Patients with HT were assessed by echocardiography and ICG. Receiver-operating characteristic curve and the area under the curve were used to assess the discriminative ability of the parameters obtained by ICG to identify LVDD, as diagnosed by echocardiography. RESULTS: ICG derived pre-ejection period (PEP), left ventricle ejection time (LVET), systolic time ratio (STR) and D wave were associated (p < 0.001) with LVDD diagnosis, with good discriminative ability: PEP (AUC 0.81; 95% CI 0.74–0.89), LVET (AUC 0.82; 95% CI 0.75–0.88), STR (AUC 0.97; 95% CI 0.94–1.00) and presence of D wave (AUC = 0.87; 95% CI 0.82–0.93). STR ≥ 0.30 outperformed the other parameters (sensitivity of 98.0%, specificity of 90.2%, positive predictive value of 95.2%, and negative predictive value of 96.1%). CONCLUSION: The ICG derived value of STR allows the accurate screening of LVDD in patients with HT. It might as well be used for follow up assessment. TRIAL REGISTRATION: The study protocol was retrospectively registered as IMPEDDANS on ClinicalTrials.gov (ID: NCT03209141) on July 6, 2017. BioMed Central 2017-12-27 /pmc/articles/PMC5744395/ /pubmed/29299336 http://dx.doi.org/10.1186/s40885-017-0084-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Nazário Leão, Rodrigo
Marques Silva, Pedro
Branco, Luísa
Fonseca, Helena
Bento, Bruno
Alves, Marta
Virella, Daniel
Palma Reis, Roberto
Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
title Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
title_full Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
title_fullStr Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
title_full_unstemmed Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
title_short Systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
title_sort systolic time ratio measured by impedance cardiography accurately screens left ventricular diastolic dysfunction in patients with arterial hypertension
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5744395/
https://www.ncbi.nlm.nih.gov/pubmed/29299336
http://dx.doi.org/10.1186/s40885-017-0084-y
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