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Factors Contributing to Energy Loss in Left Ventricle during Diastolic and Systolic Phases in Elderly Patients.
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  • Shutaro Futami,
  • Joji Ishikawa,
  • Teppei Maeda,
  • Masuyo Kawano,
  • Chieko Sakurayama,
  • Kazumasa Harada
Shutaro Futami
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Joji Ishikawa
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Teppei Maeda
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Masuyo Kawano
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Chieko Sakurayama
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Kazumasa Harada
Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology
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Abstract

Background: The change of left ventricular function deteriorated with age because of gradual increases of blood pressure may result in increased energy loss (EL) in left ventricle (LV). The present study investigated EL in LV among hypertensive elderly patients and examined factors contributing to EL. Methods: A single-center retrospective study was performed on elderly hypertensive outpatients (65 years) who underwent echocardiography (N=105). EL in the LV was measured using an vector flow mapping system, and factors affecting peak EL during the early diastolic phase (ED-EL), late diastolic phase (LD-EL), and systolic phase (Sys-EL) were evaluated. Result: Mean age was 79.9±6.4 years (male 43%). Mean ED-EL, LD-EL, and Sys-EL were 42.1±46.7, 75.6±60.2, and 40.4±40.2 mJ/N/s. In a stepwise regression analysis, the E wave peak velocity of transmitral flow (unstandardized B=0.002, 95%CI 0.001 to 0.002, standardized β=0.547, p<0.001) and stroke volume in the LV outflow tract (LVOT) (B=0.001, 95%CI 0.000 to 0.001, β=0.190, p=0.034) were identified as factors affecting ED-EL. The factors affecting LD-EL were the E/A ratio (B=-0.122, 95%CI -0.180 to -0.064, β=-0.451, p<0.001) and peak velocity in LVOT (unstandardized B=0.001, 95%CI 0.0001 to 0.001, β=0.339, p=0.003). The factors influencing Sys-EL were peak velocity in LVOT (B=0.001, 95%CI 0.001 to 0.001, β=0.619, p<0.001) and the E/A ratio (B=-0.050, 95%CI -0.087 to -0.013, β=-0.241, p=0.008). Conclusion: Peak EL in the LV was higher during diastolic phase than systolic phase among elderly hypertensive patients. Peak EL during each phase was affected by systolic blood flow in LVOT and LV transmitral flow.

Peer review status:Published

19 Jul 2020Submitted to Echocardiography
20 Jul 2020Submission Checks Completed
20 Jul 2020Assigned to Editor
21 Jul 2020Reviewer(s) Assigned
24 Aug 2020Review(s) Completed, Editorial Evaluation Pending
24 Aug 2020Editorial Decision: Revise Major
20 Oct 20201st Revision Received
22 Oct 2020Submission Checks Completed
22 Oct 2020Assigned to Editor
22 Oct 2020Reviewer(s) Assigned
27 Oct 2020Review(s) Completed, Editorial Evaluation Pending
28 Oct 2020Editorial Decision: Accept
21 Nov 2020Published in Echocardiography. 10.1111/echo.14930