Key result
Hypertension, even without left ventricular hypertrophy, is associated with reduced mitral annulus systolic and diastolic velocities, which inversely correlate with LV mass index (P<0.0001).
Why the study?
Does hypertension with or without left ventricular hypertrophy reduce longitudinal mitral annulus velocities compared to normotensive subjects?
Cross-Sectional (n=54)
Does hypertension with or without left ventricular hypertrophy reduce longitudinal mitral annulus velocities compared to normotensive subjects?
Answers are grounded in this paper and cite their sources.
May flag subclinical LV impairment in hypertension without LVH; hypothesis-generating and requires prospective validation before clinical use.
Normotensive and hypertensive subjects with and without left ventricular (LV) hypertrophy (LV mass index [LVMI] >51 g/m(2.7)) were examined by conventional echocardiography and tissue Doppler imaging of mitral annulus motion. The subgroups included nonobese normotensive subjects (n=16; age 51+/-9 years; 11 female; systolic blood pressure [SBP] 109+/-11 mm Hg, body mass index [BMI] 24+/-2.7 kg/m2; LVMI 32+/-5.5 g/m(2.7)), nonobese hypertensive subjects without LV hypertrophy (n=16; age 54+/-12 years; 12 female; SBP 166+/-15 mm Hg; BMI 25+/-2.7 kg/m2; LVMI 42+/-5.5 g/m(2.7)), and hypertensive subjects with LV hypertrophy (n=22; age 56+/-10 years; 10 female; SBP 181+/-19 mm Hg; BMI 26+/-2.3 kg/m2; LVMI 69+/-16 g/m(2.7)). Ejection fraction was comparable among the subgroups, but midwall fractional shortening was reduced in hypertensive subjects with LV hypertrophy (approximately 26%). Isovolumic relaxation time was increased in subjects with LV hypertrophy, whereas mitral wave A velocity was increased in hypertensive subjects with and without LV hypertrophy. Tissue Doppler imaging mitral annulus systolic (SM) and diastolic (EM) velocities were reduced in subjects with and without LV hypertrophy compared with normotensive subjects. There was a positive correlation between SM and EM (r=0.68; P<0.0001) and negative correlations between these 2 variables and LVMI (SM, r=-0.41; P=0.002; EM, r=-0.56; P<0.0001). Thus, reductions in mitral annulus systolic and diastolic velocities parallel increases in LV mass in hypertensive subjects, beginning at LV mass within the clinically defined normal values.
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Borges et al. (2006) conducted a cross-sectional in Hypertension and Left Ventricular Hypertrophy (n=54). Hypertension with or without left ventricular hypertrophy vs. Normotensive subjects was evaluated on Mitral annulus systolic (SM) and diastolic (EM) velocities (r=-0.56 for EM and LVMI, p=<0.0001). Hypertension, even without left ventricular hypertrophy, is associated with reduced mitral annulus systolic and diastolic velocities, which inversely correlate with LV mass index (P<0.0001).
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