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Left ventricular mass and systolic dysfunction in essential hypertension
G Schillaci1, G Vaudo, L Pasqualini
1Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Italy. skill@unipg.it
Journal of Human Hypertension
|February 19, 2002
Summary
Left ventricular (LV) hypertrophy is linked to reduced systolic function in hypertension, even after accounting for geometry. LV hypertrophy independently predicts subclinical LV dysfunction, regardless of chamber shape changes.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Left ventricular (LV) hypertrophy is associated with impaired midwall systolic function in hypertensive patients.
- Concentric geometry is a significant confounder, influencing both systolic function and LV mass.
Purpose of the Study:
- To determine the independent contribution of LV mass to depressed systolic function in never-treated essential hypertension.
- To differentiate the effects of LV mass from relative wall thickness on systolic function.
Main Methods:
- M-mode echocardiography with two-dimensional guidance was performed on 1827 never-treated essential hypertensive patients.
- Statistical analyses included correlation, multiple linear regression, and assessment within relative wall thickness quintiles.
Main Results:
- Relative wall thickness was the strongest determinant of reduced midwall fractional shortening (r = -0.63).
- An inverse relation between LV mass and midwall fractional shortening persisted after adjusting for relative wall thickness (partial r = -0.27).
- LV hypertrophy was associated with subnormal systolic function across multiple relative wall thickness strata and was an independent predictor of reduced midwall fractional shortening.
Conclusions:
- The association between LV mass and midwall systolic function is partly independent of relative wall thickness.
- LV hypertrophy contributes to subclinical LV dysfunction independently of changes in cardiac geometry.