In-treatment midwall and endocardial fractional shortening predict cardiovascular outcome in hypertensive patients with preserved baseline systolic ventricular function: the Losartan Intervention For Endpoint reduction study
In-treatment midwall and endocardial fractional shortening predict cardiovascular outcome in hypertensive patients with preserved baseline systolic ventricular function: the Losartan Intervention For Endpoint reduction study
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DOI：
10.1097/hjh.0b013e328339f943
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发表时间：
2010-07-01
影响因子：
4.9
通讯作者：
Devereux, Richard B.
中科院分区：
文献类型：
--
作者：
Wachtell, Kristian;Gerdts, Eva;Devereux, Richard B.
背景左室肥厚患者心内膜短轴缩短率(EFS)和中壁短轴缩短率(MWS)受损。然而，在治疗过程中改善左心室收缩功能是否能降低高血压患者的心血管并发症和死亡率仍是个未知数。方法对840例高血压患者进行超声心动图检查，这些患者的基础左心室射血分数大于或等于50%。在3914个病人年的随访中，基线和年度EFS、MWS和血压(BP)水平与复合终点(心血管死亡、心肌梗死或中风)和成分终点的发生有关。结果调整住院BP、左室质量、相对室壁厚度和随机治疗，较高的EFS与较低的心肌梗死(按标准差35%[4.5%]，P=0.004)和心力衰竭(49%，P
Background Endocardial fractional shortening (EFS) and midwall shortening (MWS) are impaired in patients with left ventricular hypertrophy. However, it remains unknown whether improvement of left ventricular systolic function during treatment reduces cardiovascular morbidity and mortality in hypertensive patients with preserved left ventricular function.Methods Echocardiograms were performed yearly in 840 hypertensive patients with electrocardiographic left ventricular hypertrophy and baseline left ventricular ejection fraction more and equal to 50%. Baseline and annual in-treatment levels of EFS, MWS and blood pressure (BP) were related to occurrence of a composite endpoint (cardiovascular death, myocardial infarction or stroke) and the component endpoints during 3914 patient-years of follow-up.Results Adjusting for in-treatment BP, left ventricular mass, relative wall thickness and randomized treatments, higher in-treatment EFS was associated with lower risk of myocardial infarction (by 35% per standard deviation [4.5%], P=0.004) and heart failure (49%, P