Key result
ECG strain pattern is not linked to worse LV diastolic abnormalities in hypertensive patients with ECG-LVH.
Why the study?
Does the presence of an ECG strain pattern identify more severe LV diastolic abnormalities in hypertensive patients with ECG-LVH?
Observational (n=791)
Does the presence of an ECG strain pattern identify more severe LV diastolic abnormalities in hypertensive patients with ECG-LVH?
p-value: p=> 0.1
In hypertensive patients with ECG-LVH, the presence of an ECG strain pattern is not independently associated with more severe left ventricular diastolic abnormalities.
ECG strain should not guide diastolic severity assessment in hypertensive LVH; leaves open its independent prognostic value.
BACKGROUND: Whether the typical electrocardiographic (ECG) strain pattern (Strain, in leads V5 and/or V6), which is associated with left ventricular hypertrophy (LVH) and LV systolic dysfunction, is independently associated with LV diastolic dysfunction is unknown. METHODS: The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study enrolled hypertensive patients with ECG-LVH, of whom 10% underwent Doppler echocardiography. LV diastolic function measures included peak mitral E and A wave velocities and their ratio (E/A); E wave deceleration time (EDT); atrial filling fraction (AFF); and isovolumic relaxation time (IVRT). Normal filling pattern was defined by E/A < 1 with EDT >or= 150 and or=60 ms; abnormal relaxation by E/A < 1 with EDT > 250 ms or IVRT > 100 ms; pseudonormal filling pattern by E/A >or= 1 associated with IVRT > 100 ms or EDT > 250 ms; restrictive pattern by E/A >or= 1 with IVRT < 100 ms and EDT < 250 ms. A combined index of LV systolic-diastolic function was also computed (isovolumic time/ejection time, modified myocardial performance index). Of LIFE echo substudy participants with all needed ECG and Doppler data (n = 791), 110 (14%) had Strain. RESULTS: Strain was associated with male gender, African-American race, diabetes, history of coronary heart disease (CHD), higher systolic blood pressure (BP), LV mass and relative wall thickness, and higher prevalences of echo-LV hypertrophy and wall motion abnormalities, and with slower heart rate (all P < 0.05). Age, diastolic BP and LV ejection fraction were similar in patients with or without Strain. Diastolic parameters, and prevalences of different LV filling patterns, did not differ significantly between patients with versus those without Strain (all P > 0.1), but modified myocardial performance index was higher with Strain (P < 0.05). Findings were consistent in multivariate analyses. The association of Strain with higher modified myocardial performance index was no longer statistically significant after accounting for LV systolic function and wall motion abnormalities. CONCLUSIONS: In hypertensive patients with ECG-LVH, the ECG Strain pattern did not identify independently those with more severe LV diastolic abnormalities.
No takes yet. Share an insight, caveat, or question.
Palmieri et al. (2006) conducted an observational in Hypertension with left ventricular hypertrophy (n=791). Electrocardiographic (ECG) strain pattern vs. No ECG strain pattern was evaluated on Left ventricular diastolic abnormalities (diastolic parameters and LV filling patterns) (p=> 0.1). In hypertensive patients with ECG-LVH, the ECG strain pattern was not significantly associated with more severe left ventricular diastolic abnormalities (P > 0.1).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: