For each measurement, three cardiac cycles were averaged. E and A velocities of transmitral inflow were PD173074 clinical trial measured and E/A ratio calculated. The mitral annular velocity was recorded at the LV septal wall by tissue Doppler echocardiography. The early diastolic velocity (E’) and ratio of E/E’ were determined.8) Two-dimensional speckle tracking echocardiography All echocardiographic recordings were obtained in digital format and stored on magneto-optical

disks for Inhibitors,research,lifescience,medical off-line analysis (Echopac TVI, GE Vingmed, Horten, Norway). Using a VIVID 7 machine with an M3S probe, we scanned apical 4-chamber and short axis views (at basal, mid and apical planes) of each patient to determine ventricular Inhibitors,research,lifescience,medical strain and rotation. Gain settings and pulse repetition frequencies were adjusted and sector size and depth were optimized to obtain a frame rate of 80-105 frames/s. Off-line analysis was performed using commercially available software on a personal computer workstation (EchoPAC platform, 2DS-software package, version 3.3, GE Medical Systems, Milwaukee, WI, USA).

Two-dimensional Inhibitors,research,lifescience,medical strain was measured as described.5),6) The endocardium was traced in an optimal frame, from which a region of interest (ROI) was automatically selected to approximate the myocardium between the endocardium and epicardium. The width of the ROI was adjusted to fit the wall thickness. The systolic peak of strain (ε) was selected between the aortic valve opening and closing times. We analyzed the strain rate curve and measured the early diastolic strain rate (SRE). Longitudinal ε was defined as the average negative longitudinal strains of 6 segments of the septum and lateral walls on apical 4-chamber views. Inhibitors,research,lifescience,medical Radial and circumferential ε were measured in 6 mid-LV segments on the mid-short axis view and averaged. As viewed from the apex, the LV apex rotates counterclockwise (positive angles) and the base Inhibitors,research,lifescience,medical rotates clockwise (negative angles) in systole. The proper basal level of the short-axis view was defined as that showing the tip

of the mitral valve and the apical level as that just proximal to the level with LV cavity obliteration at end-systole. Basal-to-apical twist was defined as the net difference in LV rotation angle at the apical and basal short axis planes. Brachial-ankle pulse wave velocity science measurement PWV was measured using an automatic wave form analyzer (VP-1000, Colin Medical Instruments, Komak, Japan). Before echocardiographic measurement, the PWV was recorded with the patient lying in the supine position at room temperature. Statistical analysis All statistical analyses were performed using SPSS (version 10.0, SPSS Inc., Chicago, IL, USA). All values are expressed as the means ± one standard deviation (continuous variables) or as counts and percentages (categorical variables).