Document Detail


Early left ventricular mechanics abnormalities in prehypertension: a two-dimensional strain echocardiography study.
MedLine Citation:
PMID:  20044741     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prehypertension predicts established hypertension. In this study, the aim was to analyze left ventricular (LV) mechanics in borderline prehypertensive (pre-HT) and hypertensive (HT) subjects through two-dimensional (2D)-strain echocardiography and then evaluate possible relations between cardiac parameters and insulin metabolism (homeostasis model assessment of insulin resistance (HOMA(IR)).
METHODS: Seventy-four consecutive newly diagnosed, untreated HT were divided, on the basis of their office blood pressure (BP) measurements, confirmed by ambulatory BP monitoring (ABPM), in 41 borderline pre-HT (ABPM: 122.5 +/- 6.7/76.2 +/- 5.2 mm Hg) and 33 never-treated mild HT (ABPM: 138.3 +/- 7.3/87.6 +/- 7.1 mm Hg). Thirty-three healthy normotensive (NT) controls (ABPM: 114.8 +/- 6.3/73.1 +/- 6.1 mm Hg) (P < 0.0001) were also studied (NT). All subjects performed 2D color Doppler and pulsed-wave tissue Doppler imaging (PW-TDI).
RESULTS: Left ventricular mass (LVM) was significantly higher in pre-HT (39.2 +/- 8.7 g/m(2.7)) and in HT (43.6 +/- 8.5 g/m(2.7)) compared with NT (30.9 +/- 7.4 g/m(2.7)) (P < 0.0001). A mild LV diastolic dysfunction was found both with Doppler mitral flow velocity and PW-TDI at mitral annulus level analysis. Longitudinal 2D strain in pre-HT (-18.9% +/- 3.4) and in HT (-18.0% +/- 3.3) was significantly lower than in NT (-23.9% +/- 3.0) (P < 0.002). These LV abnormalities were associated with systolic ABPM, LVM, and HOMA(IR).
CONCLUSIONS: Early abnormalities of LV longitudinal systolic deformation were found both in pre-HT and HT, together with a mild LV diastolic dysfunction. In both groups this early cardiac systolic and diastolic dysfunction is associated to insulin resistance, systolic pressure load, and cardiac remodeling.
Authors:
Vitantonio Di Bello; Enrica Talini; Giulia Dell'Omo; Cristina Giannini; Maria Grazia Delle Donne; Maria Laura Canale; Carmela Nardi; Caterina Palagi; Frank Lloyd Dini; Giuseppe Penno; Stefano Del Prato; Mario Marzilli; Roberto Pedrinelli
Publication Detail:
Type:  Journal Article     Date:  2009-12-31
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-19     Completed Date:  2010-06-04     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  405-12     Citation Subset:  IM    
Affiliation:
Cardiac and Thoracic and Vascular Department, University of Pisa, Pisa, Italy. vdibello@med.unipi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism
Blood Pressure Determination
Cholesterol / blood
Echocardiography
Female
Humans
Hypertension / blood,  physiopathology,  ultrasonography*
Hypertrophy, Left Ventricular / physiopathology,  ultrasonography
Insulin / blood
Insulin Resistance
Male
Middle Aged
Triglycerides / blood
Ventricular Dysfunction, Left / ultrasonography*
Ventricular Remodeling
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Triglycerides; 11061-68-0/Insulin; 57-88-5/Cholesterol

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