We tested the hypothesis that abnormal left ventricular(LV) relaxation is associated with concentric LV geometry. Methods and results: Doppler LV filling properties were studied in 1384 hypertensive participants witho...We tested the hypothesis that abnormal left ventricular(LV) relaxation is associated with concentric LV geometry. Methods and results: Doppler LV filling properties were studied in 1384 hypertensive participants without cardiovascular disease, from the HyperGEN population(731 women, 784 obese, 236 diabetic) and compared in four LV geometry groups; normal, concentric remodelling(3.5% ), eccentric(23% ), and concentric LV hypertrophy(4% ), based on echocardiographic LV mass index(in g/m2.7). Abnormal LV relaxation was identified by European Society of Cardiology criteria in 275 subjects(20% ). After accounting for significant confounders, E/A ratio and isovolumic relaxation time were not related to the presence of LV hypertrophy, but indicated abnormal relaxation when LV geometry was concentric(both P< 0.0001). Deceleration time of E velocity was prolonged with LV hypertrophy(P< 0.03), but the behaviour in relation to concentric LV geometry differed in the presence(prolonged) or absence(reduced) of LV hypertrophy(P=0.05), a difference independently related to the magnitude of both transmitral gradients and stroke volume(all P< 0.05). Logistic regression showed that, compared with normal LV geometry, the odds of abnormal LV relaxation was 2.3- fold greater when LV geometry was concentric and that LV hypertrophy conferred a borderline higher risk than normal LV mass. Conclusions: In hypertensive individuals without prevalent cardiovascular disease from a multi-ethnic population-based sample, delayed LV relaxation is independently associated with concentric LV geometry.展开更多
Background: Arterial hypertension determines distinct adaptive left ven tricula r geometric responses, which may differently affect left ventricular function an d left atrial performance. Objectives: In this study, th...Background: Arterial hypertension determines distinct adaptive left ven tricula r geometric responses, which may differently affect left ventricular function an d left atrial performance. Objectives: In this study, the effect of left ventr ic ular geometry on left atrial size and function, and the relationship between lef t atrial size and left ventricular mass were assessed in 336 patients with syste mic arterial hypertension who had undergone Doppler echocardiography. Methods an d results: Patients were classified into concentric (110 patients with concentri c left ventricular geometry defined as relative wall thickness ≥0.44) and eccen tric groups (226 patients with relative wall thickness< 0.44). Comparison to the latter, the former had greater left atrial size, left atrial ejection force, le ft ventricular mass and lower left ventricular midwall fractional shortening. Le ft ventricular concentric, rather than eccentric, geometry emerged by multivaria te analysis as a factor independently associated with the highest degree of left atrial ejection force. Left atrial size was positively related to left ventricu lar mass in the whole population (r=0.65, SEE=6 ml, P < 0.00001). This relations hip was maintained in the subgroups with concentric(r=0.65, SEE =6 ml, P < 0.000 01) or eccentric geometry (r=0.59,SEE= 6 ml, P < 0.00001). Conclusions: Our resu lts indicate that the relationship of left ventricular geometry to both left atr ial size and ejection force in hypertensive patients is relevant. Concentric lef t ventricular geometry is associated with greater left atrial size and ejection force than eccentric geometry, suggesting that increased left ventricular stiffn ess has a greater effect in stimulating left atrial performance than left ventri cular endsystolic stress. The degree of left atrial enlargement similarly depend s on left ventricularmass in patients with concentric and eccentric geometry.展开更多
文摘We tested the hypothesis that abnormal left ventricular(LV) relaxation is associated with concentric LV geometry. Methods and results: Doppler LV filling properties were studied in 1384 hypertensive participants without cardiovascular disease, from the HyperGEN population(731 women, 784 obese, 236 diabetic) and compared in four LV geometry groups; normal, concentric remodelling(3.5% ), eccentric(23% ), and concentric LV hypertrophy(4% ), based on echocardiographic LV mass index(in g/m2.7). Abnormal LV relaxation was identified by European Society of Cardiology criteria in 275 subjects(20% ). After accounting for significant confounders, E/A ratio and isovolumic relaxation time were not related to the presence of LV hypertrophy, but indicated abnormal relaxation when LV geometry was concentric(both P< 0.0001). Deceleration time of E velocity was prolonged with LV hypertrophy(P< 0.03), but the behaviour in relation to concentric LV geometry differed in the presence(prolonged) or absence(reduced) of LV hypertrophy(P=0.05), a difference independently related to the magnitude of both transmitral gradients and stroke volume(all P< 0.05). Logistic regression showed that, compared with normal LV geometry, the odds of abnormal LV relaxation was 2.3- fold greater when LV geometry was concentric and that LV hypertrophy conferred a borderline higher risk than normal LV mass. Conclusions: In hypertensive individuals without prevalent cardiovascular disease from a multi-ethnic population-based sample, delayed LV relaxation is independently associated with concentric LV geometry.
文摘Background: Arterial hypertension determines distinct adaptive left ven tricula r geometric responses, which may differently affect left ventricular function an d left atrial performance. Objectives: In this study, the effect of left ventr ic ular geometry on left atrial size and function, and the relationship between lef t atrial size and left ventricular mass were assessed in 336 patients with syste mic arterial hypertension who had undergone Doppler echocardiography. Methods an d results: Patients were classified into concentric (110 patients with concentri c left ventricular geometry defined as relative wall thickness ≥0.44) and eccen tric groups (226 patients with relative wall thickness< 0.44). Comparison to the latter, the former had greater left atrial size, left atrial ejection force, le ft ventricular mass and lower left ventricular midwall fractional shortening. Le ft ventricular concentric, rather than eccentric, geometry emerged by multivaria te analysis as a factor independently associated with the highest degree of left atrial ejection force. Left atrial size was positively related to left ventricu lar mass in the whole population (r=0.65, SEE=6 ml, P < 0.00001). This relations hip was maintained in the subgroups with concentric(r=0.65, SEE =6 ml, P < 0.000 01) or eccentric geometry (r=0.59,SEE= 6 ml, P < 0.00001). Conclusions: Our resu lts indicate that the relationship of left ventricular geometry to both left atr ial size and ejection force in hypertensive patients is relevant. Concentric lef t ventricular geometry is associated with greater left atrial size and ejection force than eccentric geometry, suggesting that increased left ventricular stiffn ess has a greater effect in stimulating left atrial performance than left ventri cular endsystolic stress. The degree of left atrial enlargement similarly depend s on left ventricularmass in patients with concentric and eccentric geometry.
