Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study

Eur Heart J. 2005 May;26(10):1039-45. doi: 10.1093/eurheartj/ehi019. Epub 2004 Nov 30.

Abstract

Aims: We tested the hypothesis that abnormal left ventricular (LV) relaxation is associated with concentric LV geometry.

Methods and results: Doppler LV filling properties were studied in 1384 hypertensive participants without cardiovascular disease, from the HyperGEN population (731 women, 784 obese, 236 diabetic) and compared in four LV geometry groups; normal, concentric remodelling (3.5%), eccentric (23%), and concentric LV hypertrophy (4%), based on echocardiographic LV mass index (in g/m(2.7)). Abnormal LV relaxation was identified by European Society of Cardiology criteria in 275 subjects (20%). After accounting for significant confounders, E/A ratio and isovolumic relaxation time were not related to the presence of LV hypertrophy, but indicated abnormal relaxation when LV geometry was concentric (both P<0.0001). Deceleration time of E velocity was prolonged with LV hypertrophy (P<0.03), but the behaviour in relation to concentric LV geometry differed in the presence (prolonged) or absence (reduced) of LV hypertrophy (P=0.05), a difference independently related to the magnitude of both transmitral gradients and stroke volume (all P<0.05). Logistic regression showed that, compared with normal LV geometry, the odds of abnormal LV relaxation was 2.3-fold greater when LV geometry was concentric and that LV hypertrophy conferred a borderline higher risk than normal LV mass.

Conclusions: In hypertensive individuals without prevalent cardiovascular disease from a multi-ethnic population-based sample, delayed LV relaxation is independently associated with concentric LV geometry.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Blood Flow Velocity
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / pathology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diastole / physiology
  • Echocardiography, Doppler
  • Female
  • Humans
  • Hypertension / pathology
  • Hypertension / physiopathology*
  • Hypertrophy, Left Ventricular / pathology
  • Hypertrophy, Left Ventricular / physiopathology*
  • Male
  • Middle Aged
  • Myocardial Contraction / physiology*
  • Obesity / pathology
  • Obesity / physiopathology
  • Stroke Volume / physiology
  • Ventricular Remodeling / physiology