TY - JOUR
T1 - Relationship between left ventricular diastolic relaxation and systolic function in hypertension
T2 - The Hypertension Genetic Epidemiology Network (HyperGEN) study
AU - Bella, Jonathan N.
AU - Palmieri, Vittorio
AU - Liu, Jennifer E.
AU - Kitzman, Dalane W.
AU - Oberman, Albert
AU - Hunt, Steven C.
AU - Hopkins, Paul N.
AU - Rao, D. C.
AU - Arnett, Donna K.
AU - Devereux, Richard B.
PY - 2001
Y1 - 2001
N2 - The relation of impaired left ventricular relaxation, as measured by prolonged isovolumic relaxation time, to ventricular systolic function in hypertension remains uncertain in population-based samples. In the Hypertension Genetic Epidemiology Network (HyperGEN) Study, echocardiograms were analyzed in 1457 hypertensive participants without diabetes, ≥2+ valvular regurgitation, or coronary disease. Impaired relaxation (isovolumic relaxation time > 100 ms) was present in 219 (15%) of the participants; they were older and had higher arterial pressure than did those with normal relaxation. Ventricular chamber size, wall thicknesses, mass, and relative wall thickness were greater, and stress-corrected midwall shortening and end-systolic stress/end-systolic volume index were lower with impaired relaxation than with normal relaxation time. Fractional shortening and ejection fraction did not differ between the groups. In logistic regression, the likelihood of prolonged isovolumic relaxation time decreased with higher stress-corrected midwall shortening (odds ratio, 0.97%; 95% confidence interval, 0.96 to 0.99), independently of age, heart rate, and ventricular mass. Neither ejection fraction nor the end-systolic stress/end-systolic volume index was independently related to isovolumic relaxation time. In hypertension, impaired left ventricular relaxation parallels ventricular midwall dysfunction but not systolic chamber function. Whether combined diastolic and systolic dysfunction identifies hypertensive patients at especially high risk of cardiovascular events requires further study.
AB - The relation of impaired left ventricular relaxation, as measured by prolonged isovolumic relaxation time, to ventricular systolic function in hypertension remains uncertain in population-based samples. In the Hypertension Genetic Epidemiology Network (HyperGEN) Study, echocardiograms were analyzed in 1457 hypertensive participants without diabetes, ≥2+ valvular regurgitation, or coronary disease. Impaired relaxation (isovolumic relaxation time > 100 ms) was present in 219 (15%) of the participants; they were older and had higher arterial pressure than did those with normal relaxation. Ventricular chamber size, wall thicknesses, mass, and relative wall thickness were greater, and stress-corrected midwall shortening and end-systolic stress/end-systolic volume index were lower with impaired relaxation than with normal relaxation time. Fractional shortening and ejection fraction did not differ between the groups. In logistic regression, the likelihood of prolonged isovolumic relaxation time decreased with higher stress-corrected midwall shortening (odds ratio, 0.97%; 95% confidence interval, 0.96 to 0.99), independently of age, heart rate, and ventricular mass. Neither ejection fraction nor the end-systolic stress/end-systolic volume index was independently related to isovolumic relaxation time. In hypertension, impaired left ventricular relaxation parallels ventricular midwall dysfunction but not systolic chamber function. Whether combined diastolic and systolic dysfunction identifies hypertensive patients at especially high risk of cardiovascular events requires further study.
KW - Diastole
KW - Echocardiography
KW - Hypertension
KW - Systole
KW - Ventricular function, left
UR - http://www.scopus.com/inward/record.url?scp=0035571532&partnerID=8YFLogxK
U2 - 10.1161/01.HYP.38.3.424
DO - 10.1161/01.HYP.38.3.424
M3 - Article
C2 - 11566916
AN - SCOPUS:0035571532
SN - 0194-911X
VL - 38
SP - 424
EP - 428
JO - Hypertension
JF - Hypertension
IS - 3
ER -