Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study
Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study
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DOI：
10.1093/eurheartj/ehi019
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发表时间：
2005-05-01
影响因子：
39.3
通讯作者：
Devereux, RB
中科院分区：
文献类型：
--
作者：
de Simone, G;Kitzman, DW;Devereux, RB
目的：我们检验了左心室（LV）舒张异常与左心室几何结构同心圆相关的假设。方法和结果：在HyperGEN人群中，对1384名无心血管疾病的高血压患者进行了多普勒LV充盈特性研究（731名女性，784名肥胖者，236名糖尿病患者），并在四个LV几何形状组中进行比较;正常、向心性重构（3.5%）、离心性（23%）和向心性LV肥大（4%），基于超声心动图LV质量指数（g/m（2.7））。根据欧洲心脏病学会标准，在275例受试者（20%）中确定了LV舒张异常。在考虑了显著的混杂因素后，E/A比值和等容舒张时间与左室肥厚的存在无关，但当左室几何形状为同心圆时表明舒张异常（均P < 0.0001）。E波减速时间随左室肥厚而延长（P < 0.03），但在左室肥厚存在（延长）或不存在（减少）的情况下，与向心性左室几何结构相关的行为不同（P = 0.05），这种差异与跨瓣压差和每搏输出量的大小独立相关（均P < 0.05）。Logistic回归分析显示，与正常的LV几何形状相比，左心室舒张异常的几率是2.3倍，当左心室几何形状是同心的，左心室肥大赋予一个边界比正常的左心室质量更高的风险。结论在高血压患者没有流行的心血管疾病从多种族人群为基础的样本，延迟左心室舒张是独立相关的同心左心室几何形状。
Aims 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/m(2.7)). 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.