Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study
Authors
Bang, Casper N.Gerdts, Eva
Aurigemma, Gerard P.
Boman, Kurt
Dahlof, Bjorn
Roman, Mary J.
Kober, Lars
Wachtell, Kristian
Devereux, Richard B.
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2013-10-01Keywords
AgedAged, 80 and over
Antihypertensive Agents
Blood Pressure
Body Mass Index
Dilatation
Double-Blind Method
Echocardiography
Electrocardiography
Female
Heart Ventricles
Hemodynamics
Humans
Hypertension
Hypertrophy, Left Ventricular
Losartan
Male
Middle Aged
Prevalence
Prospective Studies
*Systole
Ventricular Function, Left
Cardiology
Cardiovascular Diseases
Metadata
Show full item recordAbstract
BACKGROUND: Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients. METHODS AND RESULTS: Nine hundred thirty-nine participants in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy had measurable LVM at enrolment. Patients with LVH (LVM/body surface area > /=116 g/m in men and > /=96 g/m in women) were divided into four groups; 'eccentric nondilated' (normal LVM/EDV and EDV), 'eccentric dilated' (increased EDV, normal LVM/EDV), 'concentric nondilated' (increased LVM/EDV with normal EDV), and 'concentric dilated' (increased LVM/EDV and EDV) and compared to patients with normal LVM. At baseline, 12% had eccentric nondilated, 20% eccentric dilated, 29% concentric nondilated, and 14% concentric dilated LVH, with normal LVM in 25%. Compared with the concentric nondilated LVH group, those with concentric dilated LVH had significantly lower pulse pressure/stroke index and ejection fraction; higher LVM index, stroke volume, cardiac output, left ventricular midwall shortening, left atrial volume and isovolumic relaxation time; and more had segmental wall motion abnormalities (all P < 0.05). Similar differences existed between patients with eccentric dilated and those with eccentric nondilated LVH (all P < 0.05). Compared with patients with normal LVM, the eccentric nondilated had higher LV stroke volume, pulse pressure/stroke index, Cornell voltage product and SBP, and lower heart rate and fewer were African-American (all P < 0.05). CONCLUSION: The new four-group classification of LVH identifies dilated subgroups with reduced left ventricular function among patients currently classified with eccentric or concentric LVH.Source
J Hypertens. 2013 Oct;31(10):2060-8. doi: 10.1097/HJH.0b013e328362bbd6. Link to article on publisher's siteDOI
10.1097/HJH.0b013e328362bbd6Permanent Link to this Item
http://hdl.handle.net/20.500.14038/30470PubMed ID
23838656Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/HJH.0b013e328362bbd6