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Association of a prothrombotic state with left-ventricular diastolic dysfunction in hypertension: a tissue-Doppler imaging study.
MedLine Citation:
PMID:  24107736     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: In hypertensive patients the propensity to develop organ damage is under the influence of several factors, including the existence of a prothrombotic state. We tested the hypothesis that an activated hemostatic system is associated with left-ventricular diastolic dysfunction as assessed by tissue-Doppler imaging (TDI).
METHODS:: In 198 patients with untreated essential hypertension free of clinically relevant cardiovascular complications, we measured plasma levels of fibrinogen, prothrombin fragment 1 + 2, D-dimer, plasminogen activator inhibitor-1, and tissue plasminogen activator, and performed conventional echocardiography and TDI.
RESULTS:: Left-ventricular diastolic dysfunction was detected in 61 patients (31%) by conventional echocardiography and in 105 patients (53%) by TDI, 39% of whom had left-ventricular hypertrophy. Left-ventricular hypertrophy was associated with increased plasma fibrinogen and prothrombin fragment 1 + 2 levels. Patients with diastolic dysfunction at TDI were older and had greater BMI, SBP, left-ventricular mass index, and plasma fibrinogen and D-dimer levels than patients with normal diastolic function. Variables of diastolic function measured both at conventional echocardiography and TDI were significantly related with age, BMI, left-ventricular mass index, and plasma fibrinogen, D-dimer, and prothrombin fragment 1 + 2. Multivariate regression analysis showed that diastolic variables obtained at TDI were related to plasma fibrinogen levels independent of covariates.
CONCLUSION:: Elevated plasma levels of fibrinogen and a prothrombotic state are associated with the presence of left-ventricular diastolic dysfunction in hypertensive patients with no evidence of ischemic heart disease and might increase the risk of diastolic heart failure.
Authors:
Cristiana Catena; Gianluca Colussi; Stefania Fedrizzi; Leonardo A Sechi
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Journal of hypertension     Volume:  31     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  2077-2084     Citation Subset:  -    
Affiliation:
Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Science, University of Udine, Udine, Italy.
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