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Relationship between left ventricular diastolic relaxation and systolic function in hypertension: The Hypertension

J N Bella1, V Palmieri, J E Liu

  • 1New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY 10021, USA.

Hypertension (Dallas, Tex. : 1979)
|September 22, 2001
PubMed

Insights

In hypertension, impaired left ventricular relaxation is linked to midwall dysfunction, not overall systolic function. This finding highlights a specific type of heart muscle abnormality in hypertensive individuals.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • The relationship between impaired left ventricular relaxation and systolic function in hypertension is not well-established in population studies.
  • Hypertension can lead to structural and functional changes in the left ventricle.

Purpose of the Study:

  • To investigate the association between impaired left ventricular relaxation and systolic function in hypertensive individuals.
  • To determine if prolonged isovolumic relaxation time in hypertension correlates with specific measures of systolic performance.

Main Methods:

  • Analysis of echocardiograms from 1457 hypertensive participants in the HyperGEN Study.
  • Exclusion criteria included diabetes, significant valvular regurgitation, and coronary disease.
  • Assessment of left ventricular relaxation (isovolumic relaxation time) and various systolic function parameters.

Main Results:

  • 15% of participants had impaired relaxation (isovolumic relaxation time >100 ms), characterized by older age and higher arterial pressure.
  • Impaired relaxation was associated with increased ventricular size, wall thickness, mass, and relative wall thickness.
  • Lower stress-corrected midwall shortening was observed in those with impaired relaxation, and this correlated inversely with prolonged isovolumic relaxation time.
  • Neither ejection fraction nor end-systolic stress/end-systolic volume index differed significantly or showed independent relationships with isovolumic relaxation time.

Conclusions:

  • Impaired left ventricular relaxation in hypertension is associated with midwall systolic dysfunction, not global systolic chamber dysfunction.
  • The findings suggest that diastolic abnormalities in hypertension may coexist with specific regional systolic impairments.
  • Further research is needed to ascertain if this combined diastolic and systolic dysfunction pattern predicts cardiovascular events in hypertensive patients.

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