Document Detail


Left ventricular function and hemodynamic features of inappropriate left ventricular hypertrophy in patients with systemic hypertension: the LIFE study.
MedLine Citation:
PMID:  11320367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Predicted left ventricular (LV) mass for sex, height (2.7), and hemodynamic load can be used as an intrapatient reference for the observed LV mass. The ratio of observed/predicted LV mass may allow more physiologically correct comparisons of LV geometry, systolic and diastolic functions, and hemodynamics among hypertensive patients. METHODS: We studied 659 participants in the LIFE (Losartan Intervention for Endpoint Reduction in Hypertension) study with both electrocardiographic and echocardiographic LV hypertrophy (68% of the echocardiographic cohort) without previous myocardial infarction. LV mass was predicted by an equation including sex, stroke work, and height (2.7). Observed/predicted LV mass > 128% defined inappropriate LV hypertrophy (iLVH). Relative wall thickness > or = 0.43 defined concentric LV geometry. Systolic myocardial dysfunction was assessed by midwall mechanics and abnormal LV relaxation by isovolumic relaxation time (IVRT). RESULTS: Compared with patients with appropriate LV hypertrophy (aLVH), those with iLVH had higher body mass index, LV mass index, relative wall thickness, prevalences of systolic myocardial dysfunction and prolonged IVRT and lower end-systolic stress and cardiac index. Patients with eccentric iLVH had the highest wall stress and lowest ejection fraction; 43% had systolic myocardial dysfunction. Of patients with concentric iLVH, 79% had systolic myocardial dysfunction but normal ejection fraction and the lowest wall stress. Systolic myocardial dysfunction was present in 12% with concentric aLVH and none with eccentric aLVH. Prevalence of prolonged IVRT was high in all 4 groups (65% to 77%). Cardiac index was similarly lower with concentric or eccentric iLVH than with aLVH. CONCLUSIONS: Among hypertensives with LV hypertrophy, iLVH identified cardiac phenotypes with a high prevalence of myocardial systolic dysfunction.
Authors:
V Palmieri; K Wachtell; E Gerdts; J N Bella; V Papademetriou; C Tuxen; M S Nieminen; B Dahlöf; G de Simone; R B Devereux
Related Documents :
2220577 - Left ventricular dilatation and pulmonary thallium uptake after single-photon emission ...
9321827 - Left ventricular volumes and function in the embryonic mouse heart.
18328857 - Mechanical right ventricular dyssynchrony in patients after atrial switch operation for...
2406037 - Intrinsic myocardial dysfunction during endotoxemia: dependent or independent of myocar...
11726887 - Is repair preferable to replacement for ischemic mitral regurgitation?
21636627 - Association of heart structure and function abnormalities with laboratory findings in p...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Evaluation Studies; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  141     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-26     Completed Date:  2001-05-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  784-91     Citation Subset:  AIM; IM    
Affiliation:
Weill Medical College of Cornell University, New York, NY, USA. vpalmier@med.cornell.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use*
Disease Progression
Echocardiography, Doppler
Electrocardiography
Female
Heart Ventricles / drug effects,  physiopathology,  ultrasonography
Hemodynamics* / drug effects,  physiology
Humans
Hypertension / complications,  drug therapy,  physiopathology*
Hypertrophy, Left Ventricular / etiology,  physiopathology*,  prevention & control
Losartan / therapeutic use*
Male
Middle Aged
Prognosis
Ventricular Function, Left / drug effects,  physiology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 114798-26-4/Losartan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Anti-human skeletal muscle glycolipid antibodies in unstable angina.
Next Document:  Uric acid in cachectic and noncachectic patients with chronic heart failure: relationship to leg vas...