Relation of impaired left ventricular filling to systolic midwall mechanics in hypertensive patients with normal left ventricular systolic chamber function: the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) study

American Heart Journal
Kristian WachtellRichard B Devereux

Abstract

Patients with hypertensive left ventricular (LV) hypertrophy commonly have diastolic dysfunction with preserved LV ejection fraction. LV systolic midwall shortening (MWS) may be impaired in hypertensive patients with normal LV ejection fraction. However, it is unclear whether impaired LV filling is related to depressed systolic midwall mechanics. Echocardiographic measures of LV diastolic filling and systolic performance were compared in 632 unmedicated patients with stage II or III hypertension and LV hypertrophy determined by electrocardiogram, with LV ejection fraction >55% and <2+ mitral regurgitation. Stress-corrected LV MWS, an index of myocardial contractility, was lower in patients with abnormal as opposed to normal LV filling patterns (98% +/- 12% vs 102% +/- 10%, P <.001) and in patients with prolonged as opposed to normal isovolumic relaxation time (IVRT) (98% +/- 13% vs 101% +/- 12%, P =.014). Stress-corrected MWS was <85% of predicted levels in more patients with abnormal LV filling patterns (11.8% vs 6.3%) or with long IVRT (> or =105 msec) (34% vs 21%, both P <.05). In regression analyses, lower stress-corrected MWS and higher LV mass were independent correlates of longer IVRT, while lower stress-corrected MWS wa...Continue Reading

References

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Citations

Feb 26, 2009·European Heart Journal·Kristian Wachtell
Dec 24, 2013·Journal of Cardiac Failure·Piercarlo BalloUNKNOWN Working Group Nucleus on Echocardiography of the Italian Society of Cardiology
Apr 20, 2013·The American Journal of Cardiology·Mahboob AlamHisham Dokainish
Sep 2, 2008·Heart Failure Clinics·Abhijit A Shinde, Allen S Anderson
Oct 1, 2016·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Ursula ReiterMichael Fuchsjäger
Mar 13, 2012·Heart Failure Clinics·Erin E Coglianese, Thomas J Wang
Dec 18, 2010·American Journal of Hypertension·Maurizio Galderisi
Oct 13, 2011·Journal of Hypertension·Kristian Wachtell, Michael Hecht Olsen

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