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Left ventricular longitudinal systolic dysfunction is an independent marker of cardiovascular risk in patients with

Piercarlo Ballo1, Daniele Barone, Arianna Bocelli

  • 1Cardiology Operative Unit, S. Andrea Hospital, La Spezia, Italy. pcballo@tin.it

American Journal of Hypertension
|August 2, 2008
PubMed

Insights

Left ventricular longitudinal systolic dysfunction, measured by AVPD and Sm, independently predicts cardiovascular events in hypertension patients. These measures offer higher sensitivity than circumferential indices for risk prediction.

Area of Science:

  • Cardiology
  • Echocardiography
  • Hypertension Research

Background:

  • Hypertension is a major risk factor for cardiovascular disease.
  • Left ventricular (LV) systolic dysfunction is a known complication of hypertension.
  • The prognostic value of longitudinal systolic dysfunction in hypertensive patients requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic significance of LV longitudinal systolic dysfunction in hypertensive individuals.
  • To compare the predictive accuracy of longitudinal systolic indices with conventional circumferential indices.

Main Methods:

  • Assessed LV longitudinal systolic function using M-mode atrioventricular plane displacement (AVPD) and Tissue Doppler-derived mitral annular peak systolic velocity (Sm) in 156 hypertensive patients.
  • Followed patients for major adverse cardiovascular events, including heart failure, myocardial infarction, stroke, and cardiovascular death.
  • Utilized multivariate analysis to determine the independent prognostic value of longitudinal indices.

Main Results:

  • Both AVPD and Sm were significant predictors of cardiovascular events (P < 0.001).
  • Specific cutoffs for AVPD (≤11.4 mm) and Sm (≤8.9 cm/s) identified patients at higher risk.
  • Longitudinal indices demonstrated higher sensitivity but lower specificity compared to circumferential indices for predicting events.
  • The combination of longitudinal and circumferential systolic dysfunction indicated the worst prognosis (P < 0.0001).

Conclusions:

  • LV longitudinal systolic dysfunction serves as an independent marker of cardiovascular risk in hypertensive patients.
  • Longitudinal indices (AVPD, Sm) are more sensitive but less specific than circumferential indices in predicting cardiovascular events.
  • These findings highlight the importance of assessing longitudinal systolic function for comprehensive cardiovascular risk stratification in hypertension.
Abstract

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