Relations of diastolic left ventricular filling to systolic chamber and myocardial contractility in hypertensive patients with left ventricular hypertrophy (the PRESERVE study)

Vittorio Palmieri, Jonathan N. Bella, Vincent Dequattro, Mary J. Roman, Rebecca T. Hahn, Bjorn Dahlof, Norman Sharpe, Chu Pak Lau, Wan Chun Chen, Esther Paran, Giovanni De Simone, Richard B. Devereux

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Abnormalities of left ventricular (LV) diastolic filling and stress-corrected midwall shortening (MWS) have been described in hypertensive patients with normal ejection fraction (EF). However, whether stress-corrected MWS parallels LV diastolic filling better than EF does remains uncertain. Blood pressure, body mass index, echocardiographic LV mass and LV geometry, EF and stress-corrected MWS, LV diastolic filling (peak E- and A-wave velocities, E-wave deceleration time, and atrial filling fraction) were evaluated in 212 hypertensive patients with LV hypertrophy enrolled in the Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement study. LV structure, geometry, as well as LV diastolic filling, were compared between patients with reduced EF (<55%, n = 39, 18%) and those with normal EF (>55%) as well as between patients with reduced stress-corrected MWS (<89.2%, n = 31, 15%) and those with normal stress-corrected MWS (>89.2%). Patients with reduced EF had higher LV mass, eccentric LV geometry, and higher heart rate than those with normal EF, although they did not differ in age, blood pressure, or body mass index. LV filling pattern was also similar in those 2 groups. Patients with reduced stress-corrected MWS had higher atrial filling fraction, body mass index, heart rate, LV mass, and concentric geometry than those with normal stress-corrected MWS. Atrial filling fraction was negatively associated with stress-corrected MWS, but not with EF in multivariate models, independently of age, gender, heart rate, and body mass index. Thus, in hypertensive patients with LV hypertrophy, abnormal LV diastolic filling is more closely related to impaired myocardial contractility than to LV chamber EF. Copyright (C) 1999 Excerpta Medica Inc.

Original languageEnglish
Pages (from-to)558-562
Number of pages5
JournalAmerican Journal of Cardiology
Volume84
Issue number5
DOIs
StatePublished - 1 Sep 1999
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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