Relations of diastolic left ventricular filling to systolic chamber and myocardial contractility in hypertensive patients with left ventricular hypertrophy (The PRESERVE study)

被引:51
作者
Palmieri, V
Bella, JN
DeQuattro, V
Roman, MJ
Hahn, RT
Dahlof, B
Sharpe, N
Lau, CP
Chen, WC
Paran, E
de Simone, G
Devereux, RB
机构
[1] Cornell Univ, New York Presbyterian Hosp, Joan & Sanford I Weill Med Coll, Dept Med,Div Cardiol, New York, NY 10021 USA
[2] Univ So Calif, Los Angeles Cty Med Ctr, White Mem Med Ctr, Los Angeles, CA 90033 USA
[3] Univ Gothenburg, Gothenburg, Sweden
[4] Auckland Hosp, Dept Med, Auckland, New Zealand
[5] Queen Mary Hosp, Dept Med, Hong Kong, Peoples R China
[6] Shanghai 6th Peoples Hosp, Dept Cardiol, Shanghai, Peoples R China
[7] Soroka Med Ctr, Hypertens Unit, Beer Sheva, Israel
关键词
D O I
10.1016/S0002-9149(99)00377-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Abnormalities of left ventricular (LV) diastolic filling and stress-corrected midwall shortening (MWS) have been described in hypertensive patients with normal ejection fraction (EF). However, whether stress-corrected MWS parallels LV diastolic filling better than EF does remains uncertain. Blood pressure, body mass index, echocardiographic LV mass and LV geometry, EF and stress-corrected MWS, LV diastolic filling (peak E- and A-wave velocities, E-wave deceleration time, and atrial filling fraction) were evaluated in 212 hypertensive patients with LV hypertrophy enrolled in the Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement study. LV structure, geometry, as well as LV diastolic filling, were compared between patients with reduced EF (<55%, n = 39, 18%) and those with normal EF (>55%) as well as between patients with reduced stress-corrected MWS (<89.2% n = 31, 15%) and those with normal stress-corrected MWS (>89.2%). Patients with reduced EF had higher LV mass, eccentric LV geometry, and higher heart rate than those with normal EF, although they did not differ in age, blood pressure, or body mass index. LV filling pattern was also similar in those 2 groups. patients with reduced stress-corrected MWS had higher atrial filling fraction, body mass index, heart rate, LV mass, and concentric geometry than those with normal stress-corrected MWS. Atrial filling fraction was negatively associated with stress-corrected MWS, but not with EF in multivariate models, independently of age, gender, heart rate, and body mass index. Thus, in hypertensive patients with LV hypertrophy, abnormal LV diastolic filling is more closely related to impaired myocardial contractility than to LV chamber EF. (C) 1999 by Excerpta Medica, Inc.
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页码:558 / 562
页数:5
相关论文
共 30 条
[11]   Comparison of Enalapril versus Nifedipine to decrease left ventricular hypertrophy in systemic hypertension - The PRESERVE trial [J].
Devereux, RB ;
Dahlof, B ;
Levy, D ;
Pfeffer, MA .
AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 (01) :61-65
[12]   ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT-VENTRICULAR HYPERTROPHY - COMPARISON TO NECROPSY FINDINGS [J].
DEVEREUX, RB ;
ALONSO, DR ;
LUTAS, EM ;
GOTTLIEB, GJ ;
CAMPO, E ;
SACHS, I ;
REICHEK, N .
AMERICAN JOURNAL OF CARDIOLOGY, 1986, 57 (06) :450-458
[13]   Left ventricular geometry and function in hypertensive patients with ECG left ventricular hypertrophy: The LIFE trial [J].
Devereux, RB ;
Bella, JN ;
Dahlof, B ;
Gerdts, E ;
Niemenen, M ;
Nielsen, J ;
Papademetriou, V .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (02) :376A-376A
[14]  
Devereux Richard B., 1999, Journal of the American College of Cardiology, V33, p497A
[15]   LEFT-VENTRICULAR DIASTOLIC FUNCTION IN HYPERTENSION - RELATION TO LEFT-VENTRICULAR MASS AND SYSTOLIC FUNCTION [J].
FOUAD, FM ;
SLOMINSKI, JM ;
TARAZI, RC .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1984, 3 (06) :1500-1506
[16]   THE PROGNOSTIC ROLE OF LEFT-VENTRICULAR HYPERTROPHY IN PATIENTS WITH OR WITHOUT CORONARY-ARTERY DISEASE [J].
GHALI, JK ;
LIAO, YL ;
SIMMONS, B ;
CASTANER, A ;
CAO, GC ;
COOPER, RS .
ANNALS OF INTERNAL MEDICINE, 1992, 117 (10) :831-836
[17]   ABNORMAL LEFT-VENTRICULAR FILLING - AN EARLY FINDING IN MILD TO MODERATE SYSTEMIC HYPERTENSION [J].
INOUYE, I ;
MASSIE, B ;
LOGE, D ;
TOPIC, N ;
SILVERSTEIN, D ;
SIMPSON, P ;
TUBAU, J .
AMERICAN JOURNAL OF CARDIOLOGY, 1984, 53 (01) :120-126
[18]   RELATION OF LEFT-VENTRICULAR MASS AND GEOMETRY TO MORBIDITY AND MORTALITY IN UNCOMPLICATED ESSENTIAL-HYPERTENSION [J].
KOREN, MJ ;
DEVEREUX, RB ;
CASALE, PN ;
SAVAGE, DD ;
LARAGH, JH .
ANNALS OF INTERNAL MEDICINE, 1991, 114 (05) :345-352
[19]   PROGNOSTIC IMPLICATIONS OF ECHOCARDIOGRAPHICALLY DETERMINED LEFT-VENTRICULAR MASS IN THE FRAMINGHAM-HEART-STUDY [J].
LEVY, D ;
GARRISON, RJ ;
SAVAGE, DD ;
KANNEL, WB ;
CASTELLI, WP .
NEW ENGLAND JOURNAL OF MEDICINE, 1990, 322 (22) :1561-1566
[20]   SURVIVAL OF MEDICALLY TREATED PATIENTS IN THE CORONARY-ARTERY SURGERY STUDY (CASS) REGISTRY [J].
MOCK, MB ;
RINGQVIST, I ;
FISHER, LD ;
DAVIS, KB ;
CHAITMAN, BR ;
KOUCHOUKOS, NT ;
KAISER, GC ;
ALDERMAN, E ;
RYAN, TJ ;
RUSSELL, RO ;
MULLIN, S ;
FRAY, D ;
KILLIP, T .
CIRCULATION, 1982, 66 (03) :562-568