Key result
Concentric left ventricular geometry in hypertensive individuals without cardiovascular disease was associated with a 2.3-fold greater odds of abnormal LV relaxation compared with normal geometry.
Why the study?
Is concentric LV geometry associated with abnormal LV relaxation in hypertensive patients without cardiovascular disease?
Cross-Sectional (n=1,384)
Is concentric LV geometry associated with abnormal LV relaxation in hypertensive patients without cardiovascular disease?
Effect estimate: OR 2.3
In hypertensive individuals without prevalent cardiovascular disease, delayed LV relaxation is independently associated with concentric LV geometry.
Supports targeted diastolic evaluation in hypertensives with concentric geometry; extends ESC criteria but remains hypothesis-generating.
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.
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Simone et al. (2004) conducted a cross-sectional in Hypertension (n=1,384). Concentric LV geometry vs. Normal LV geometry was evaluated on Abnormal LV relaxation (OR 2.3). Concentric left ventricular geometry in hypertensive individuals without cardiovascular disease was associated with a 2.3-fold greater odds of abnormal LV relaxation compared with normal geometry.