PMID- 27367264
OWN - NLM
STAT- MEDLINE
DCOM- 20170912
LR  - 20181202
IS  - 1473-5598 (Electronic)
IS  - 0263-6352 (Linking)
VI  - 34
IP  - 9
DP  - 2016 Sep
TI  - Depressed myocardial energetic efficiency is associated with increased 
      cardiovascular risk in hypertensive left ventricular hypertrophy.
PG  - 1846-53
LID - 10.1097/HJH.0000000000001007 [doi]
AB  - BACKGROUND AND PURPOSE: Myocardial mechano-energetic efficiency (MEE) can be 
      easily approximated by the ratio of stroke work [i.e. SBP times stroke volume 
      (SV)] to a rough estimate of energy consumption, the 'double product' [SBP times 
      heart rate (HR)], which can be simplified as SV/HR. We evaluated whether MEE is 
      associated with adverse prognosis in relation to the presence of left ventricular 
      hypertrophy (LVH). METHODS: Hypertensive participants of the Campania Salute 
      Network (n = 12 353) without prevalent coronary or cerebrovascular disease and 
      with ejection fraction more than 50% were cross-sectionally and longitudinally 
      analyzed, over a median follow-up of 31 months. MEE was estimated by 
      echocardiographic SV (z-derived)/(HR x 0.6). RESULTS: Due to the close relation 
      with left ventricular mass (LVM) (P < 0.0001), MEE was normalized for LVM (MEEi) 
      and divided into quartiles. The lowest quartile of MEEi (<0.29 ml/s per g) was 
      considered 'low MEEi'. MEEi was greater in women than in men (P < 0.0001). 
      Progressively lower MEEi was associated with older age, male sex, obesity, 
      diabetes, LVH, concentric geometry, inappropriate LVM and diastolic dysfunction, 
      more use of antihypertensive therapy, and higher BP (all P < 0.002). In Cox 
      regression, after controlling for LVH, age, sex, and average follow-up SBP, low 
      MEEi exhibited increased hazard of composite fatal and nonfatal cardiovascular 
      end-points (P < 0.01), independently of antihypertensive therapy and associated 
      cardiovascular risk factors. CONCLUSION: A simple estimate of low myocardial 
      mechano-energetic efficiency is associated with altered metabolic profile, LVH, 
      concentric left ventricular geometry, and diastolic dysfunction and predicts 
      cardiovascular end-points, independently of age, sex, LVH antihypertensive 
      therapy, and cardiovascular risk factors.
FAU - de Simone, Giovanni
AU  - de Simone G
AD  - aHypertension Research Center bDepartment of Advanced Translational Medical 
      Sciences cDepartment of Biomedical Sciences dDepartment of Neurosciences, 
      Federico II University Hospital, Napoli, Italy.
FAU - Izzo, Raffaele
AU  - Izzo R
FAU - Losi, Maria Angela
AU  - Losi MA
FAU - Stabile, Eugenio
AU  - Stabile E
FAU - Rozza, Francesco
AU  - Rozza F
FAU - Canciello, Grazia
AU  - Canciello G
FAU - Mancusi, Costantino
AU  - Mancusi C
FAU - Trimarco, Valentina
AU  - Trimarco V
FAU - De Luca, Nicola
AU  - De Luca N
FAU - Trimarco, Bruno
AU  - Trimarco B
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - J Hypertens
JT  - Journal of hypertension
JID - 8306882
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Blood Pressure
MH  - Cardiovascular Diseases/epidemiology
MH  - Cross-Sectional Studies
MH  - Echocardiography
MH  - Energy Metabolism
MH  - Female
MH  - Heart/*physiopathology
MH  - Humans
MH  - Hypertension/complications/*physiopathology
MH  - Hypertrophy, Left Ventricular/complications/*physiopathology
MH  - Italy/epidemiology
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Myocardium
MH  - Prognosis
MH  - Risk Factors
MH  - *Stroke Volume
EDAT- 2016/07/02 06:00
MHDA- 2017/09/13 06:00
CRDT- 2016/07/02 06:00
PHST- 2016/07/02 06:00 [entrez]
PHST- 2016/07/02 06:00 [pubmed]
PHST- 2017/09/13 06:00 [medline]
AID - 10.1097/HJH.0000000000001007 [doi]
PST - ppublish
SO  - J Hypertens. 2016 Sep;34(9):1846-53. doi: 10.1097/HJH.0000000000001007.