PMID- 10637202
OWN - NLM
STAT- MEDLINE
DCOM- 20000201
LR  - 20190623
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 101
IP  - 2
DP  - 2000 Jan 18
TI  - Relation of left ventricular diastolic properties to systolic function in 
      arterial hypertension.
PG  - 152-7
AB  - BACKGROUND: It is unclear whether impairment of left ventricular (LV) diastolic 
      characteristics is independent of systolic dysfunction. METHODS AND RESULTS: To 
      address this issue, 159 consecutive hypertensive patients (44+/-11 years, 78 
      obese, 96 women) and 165 normotensive subjects (32+/-11 years, 84 obese, 110 
      women) were studied with the use of Doppler echocardiography. After adjustment 
      for age, body mass index (BMI), and sex, we found that ejection fraction (EF; 
      M-mode, z-derived) was higher in hypertensive (66. 6+/-5.2%) than in normotensive 
      (63.9+/-4.4%, P<0.0001) subjects, whereas midwall shortening (MS) was lower 
      (hypertensive patients 16. 9+/-2.0%, normotensive subjects 17.8+/-2.2%, P<0.02), 
      even after correction for end-systolic wall stress (P<0.05). Isovolumic 
      relaxation time (IVRT) was greater in hypertensive patients (103+/-14 ms) than in 
      normotensive subjects (78+/-19 ms), as was deceleration time of E velocity and 
      peak A velocity (all P<0.0001). In multivariate analysis, IVRT was unrelated to 
      EF, but a negative relation was found with MS (P<0.001), independent of age, BMI, 
      presence of arterial hypertension, LV geometry, and load (multiple R(2)=0.58). 
      For comparable age, sex distribution, BMI, and blood pressure values, 
      hypertensive patients with lower afterload-adjusted MS exhibited longer IVRT than 
      patients with normal MS (P<0.005). However, IVRT remained higher than in 
      normotensive control subjects after control for LV geometry and load. 
      CONCLUSIONS: Doppler indices of delayed LV relaxation can be detected in the 
      presence of normal or supranormal EF but are independently related to impaired 
      MS. A less severely abnormal relaxation, however, can be also detected in the 
      presence of normal midwall function, independent of LV geometry and load. Thus, 
      diastolic abnormalities may occur before systolic dysfunction even when it is 
      measured at the midwall.
FAU - de Simone, G
AU  - de Simone G
AD  - Department of Clinical and Experimental Medicine, Federico II University 
      Hospital, Naples, Italy. simogi@unina.it
FAU - Greco, R
AU  - Greco R
FAU - Mureddu, G
AU  - Mureddu G
FAU - Romano, C
AU  - Romano C
FAU - Guida, R
AU  - Guida R
FAU - Celentano, A
AU  - Celentano A
FAU - Contaldo, F
AU  - Contaldo F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Adult
MH  - Diastole
MH  - Echocardiography
MH  - Female
MH  - Heart/physiopathology
MH  - Humans
MH  - Hypertension/*physiopathology
MH  - Hypertrophy, Left Ventricular/diagnostic imaging/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Obesity/physiopathology
MH  - Stroke Volume
MH  - Systole
MH  - Time Factors
MH  - *Ventricular Dysfunction, Left
EDAT- 2000/01/19 00:00
MHDA- 2000/01/19 00:01
CRDT- 2000/01/19 00:00
PHST- 2000/01/19 00:00 [pubmed]
PHST- 2000/01/19 00:01 [medline]
PHST- 2000/01/19 00:00 [entrez]
AID - 10.1161/01.cir.101.2.152 [doi]
PST - ppublish
SO  - Circulation. 2000 Jan 18;101(2):152-7. doi: 10.1161/01.cir.101.2.152.