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Echocardiographic wall motion abnormalities in hypertensive patients with electrocardiographic left ventricular
Vittorio Palmieri1, Peter M Okin, Jonathan N Bella
1Cornell Medical Center, New York, New York, USA. vpalmier@med.cornell.edu
Insights
In hypertensive patients with left ventricular hypertrophy, mild wall motion abnormalities were found in 13% and linked to male gender, higher albuminuria, and left ventricular hypertrophy. These findings highlight key correlates of cardiac dysfunction in this population.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Left ventricular hypertrophy (LVH) is common in hypertension.
- Information on left ventricular wall motion (WM) abnormalities in hypertensive patients with LVH is limited.
- Echocardiography is crucial for assessing cardiac structure and function.
Purpose of the Study:
- To determine the prevalence of echocardiographic global and segmental left ventricular WM abnormalities.
- To identify correlates of these WM abnormalities in hypertensive patients with LVH.
- To compare WM abnormalities between global and segmental types.
Main Methods:
- Analysis of 942 hypertensive patients with LVH from the LIFE echo substudy.
- Classification of patients into normal WM, segmental WM abnormalities, or global WM abnormalities groups.
- Statistical analysis to identify correlates of WM abnormalities.
Main Results:
- Mild WM abnormalities (segmental or global) were detected in 13% of the study sample.
- Patients with WM abnormalities were more likely to be male and have higher albuminuria and Cornell voltage-duration product.
- Independent correlates included male gender, echo-LVH, higher albuminuria, and lower cholesterol levels.
Conclusions:
- Echocardiographic WM abnormalities are present in a notable proportion of hypertensive patients with LVH.
- Albuminuria, male gender, and LVH are significant correlates of WM abnormalities.
- These findings underscore the importance of comprehensive cardiovascular risk assessment in hypertensive individuals.
Abstract:
There is limited information on correlates of left ventricular wall motion (WM) abnormalities in ambulatory patients with hypertension and ECG left ventricular hypertrophy by Cornell voltage-duration product and/or Sokolow-Lyon voltage criteria. Therefore, we assessed the prevalence and the correlates of echocardiographic global and segmental left ventricular WM abnormalities in 942 hypertensive patients with hypertrophy enrolled in the Losartan Intervention For End-point reduction in hypertension (LIFE) echo substudy. Patients were separated into groups of those with normal WM or those with segmental or global WM abnormalities. Segmental and global WM abnormalities were mostly of mild degree and were detected in 7% and 6% of the study sample. Compared with subjects with normal motion, those with WM abnormalities were mostly men and had higher prevalences of self-reported coronary heart disease, ECG signs of myocardial infarction, ST-strain pattern, and higher Cornell voltage-duration product, echo-left ventricular mass, and albuminuria, but lower total and high-density lipoprotein cholesterol. Blood pressure was similar among groups. No significant differences were found between patients with global or segmental WM abnormalities. Only half of patients with WM abnormalities had a history or ECG signs of coronary heart disease. Independent correlates of WM abnormalities were higher albuminuria and Cornell voltage-duration product, male gender, and echo-left ventricular hypertrophy, but lower cholesterol. In a subanalysis restricted to patients with WM abnormalities, those with evident cardiovascular disease had a higher prevalence of ST-strain pattern than those with subclinical WM abnormalities, but other clinical, ECG, or echocardiographic parameters were indistinguishable between the 2 groups. Thus, in hypertensives with ECG left ventricular hypertrophy, WM abnormalities, mostly of mild degree, occurred in one eighth of the patients and were associated with male gender, left ventricular hypertrophy, and albuminuria. No significant differences were found between patients with global or segmental wall motion abnormalities.