摘要
We tested the hypothesis that abnormal left ventricular(LV) relaxation is associated with concentric LV geometry. Methods and results: Doppler LV filling properties were studied in 1384 hypertensive participants without cardiovascular disease, from the HyperGEN population(731 women, 784 obese, 236 diabetic) and compared in four LV geometry groups; normal, concentric remodelling(3.5% ), eccentric(23% ), and concentric LV hypertrophy(4% ), based on echocardiographic LV mass index(in g/m2.7). Abnormal LV relaxation was identified by European Society of Cardiology criteria in 275 subjects(20% ). After accounting for significant confounders, E/A ratio and isovolumic relaxation time were not related to the presence of LV hypertrophy, but indicated abnormal relaxation when LV geometry was concentric(both P< 0.0001). Deceleration time of E velocity was prolonged with LV hypertrophy(P< 0.03), but the behaviour in relation to concentric LV geometry differed in the presence(prolonged) or absence(reduced) of LV hypertrophy(P=0.05), a difference independently related to the magnitude of both transmitral gradients and stroke volume(all P< 0.05). Logistic regression showed that, compared with normal LV geometry, the odds of abnormal LV relaxation was 2.3- fold greater when LV geometry was concentric and that LV hypertrophy conferred a borderline higher risk than normal LV mass. Conclusions: In hypertensive individuals without prevalent cardiovascular disease from a multi-ethnic population-based sample, delayed LV relaxation is independently associated with concentric LV geometry.
We tested the hypothesis that abnormal left ventricular(LV) relaxation is associated with concentric LV geometry. Methods and results: Doppler LV filling properties were studied in 1384 hypertensive participants without cardiovascular disease, from the HyperGEN population(731 women, 784 obese, 236 diabetic) and compared in four LV geometry groups; normal, concentric remodelling(3.5% ), eccentric(23% ), and concentric LV hypertrophy(4% ), based on echocardiographic LV mass index(in g/m2.7). Abnormal LV relaxation was identified by European Society of Cardiology criteria in 275 subjects(20% ). After accounting for significant confounders, E/A ratio and isovolumic relaxation time were not related to the presence of LV hypertrophy, but indicated abnormal relaxation when LV geometry was concentric(both P< 0.0001). Deceleration time of E velocity was prolonged with LV hypertrophy(P< 0.03), but the behaviour in relation to concentric LV geometry differed in the presence(prolonged) or absence(reduced) of LV hypertrophy(P=0.05), a difference independently related to the magnitude of both transmitral gradients and stroke volume(all P< 0.05). Logistic regression showed that, compared with normal LV geometry, the odds of abnormal LV relaxation was 2.3- fold greater when LV geometry was concentric and that LV hypertrophy conferred a borderline higher risk than normal LV mass. Conclusions: In hypertensive individuals without prevalent cardiovascular disease from a multi-ethnic population-based sample, delayed LV relaxation is independently associated with concentric LV geometry.
