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The Impact of Hypertension as a Road to Heart Failure with Preserved Ejection Fraction: Diagnostic Value of Two-Dimensional Speckle Tracking Echocardiography for the Early Impairment of Left Atrial-Left Ventricular-Arterial Coupling

[ Vol. 10 , Issue. 4 ]


Takashi Oki, Hirokazu Miyoshi, Yoshifumi Oishi, Yukio Mizuguchi, Nusrat Ara and Arata Iuch   Pages 177 - 188 ( 12 )


Heart failure with preserved ejection fraction (HFPEF) is a syndrome that frequently occurs in older people and patients with cardiovascular risk factors, particularly hypertension. This syndrome is not a specific disease process, whereas is associated with high morbidity and mortality in patients with heart failure with reduced ejection fraction (HFREF) as well. Therefore, a “one size fits all” diagnosis strategy is unlikely to operate for patients with HFPEF. Assessment of left atrial (LA)-left ventricular (LV)-arterial coupling seems to have a clinical impact on hypertensive patients, because HF signs and symptoms have been found to be significantly related to inappropriate LA-LV interaction during diastole and LV-arterial interaction during systole. Two-dimensional speckle tracking echocardiography (2DSTE) is a new tool that may have a role in earlier detecting the impaired LA, LV, and arterial function in asymptomatic patients. This review explored the impact of LA-LV-arterial coupling in understanding the pathophysiology of hypertension as a road to HFPEF, and the possibilities of clinical application by using 2DSTE.


Heart failure with preserved ejection fraction, hypertension, left atrial-left ventricular-arterial coupling, twodimensional speckle tracking echocardiography.


Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, 1-1 Ohmukaikita, Ohtera, Itano, Itano, Tokushima 779-0193, Japan.

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