Longitudinal mitral annulus velocities are reduced in hypertensive subjects with or without left ventricle hypertrophy

Normotensive and hypertensive subjects with and without left ventricular (LV) hypertrophy (LV mass index [LVMI] > 51 g/m(2.7)) were examined by conventional echocardiography and tissue Doppler imaging of mitral annulus motion. The subgroups included nonobese normotensive subjects (n = 16; age 51 +/- 9 years; 11 female; systolic blood pressure [SBP] 109 +/- 11 mm Hg, body mass index [BMI] 24 +/- 2.7 kg/m(2); LVMI 32 +/- 5.5 g/m(2.7)), nonobese hypertensive subjects without LV hypertrophy (n = 16; age 54 +/- 12 years; 12 female; SBP 166 +/- 15 mm Hg; BMI 25 +/- 2.7 kg/m(2); LVMI 42 +/- 5.5 g/m(2.7)), and hypertensive subjects with LV hypertrophy (n = 22; age 56 +/- 10 years; 10 female; SBP 181 +/- 19 mm Hg; BMI 26 +/- 2.3 kg/m(2); LVMI 69 +/- 16 g/m(2.7)). Ejection fraction was comparable among the subgroups, but midwall fractional shortening was reduced in hypertensive subjects with LV hypertrophy (approximate to 26%). Isovolumic relaxation time was increased in subjects with LV hypertrophy, whereas mitral wave A velocity was increased in hypertensive subjects with and without LV hypertrophy. Tissue Doppler imaging mitral annulus systolic (S-M) and diastolic (E-M) velocities were reduced in subjects with and without LV hypertrophy compared with normotensive subjects. There was a positive correlation between SM and EM (r = .68; P < 0.0001) and negative correlations between these 2 variables and LVMI (S-M, r = -0.41; P = 0.002; E-M, r = -0.56; P < 0.0001). Thus, reductions in mitral annulus systolic and diastolic velocities parallel increases in LV mass in hypertensive subjects, beginning at LV mass within the clinically defined normal values.