Echocardiographic evaluation of cardiac structure and function in elderly subjects with isolated systolic hypertension

Department of Internal Medicine, University Hospital, St. Louis University School of Medicine, Missouri.

One hundred four participants in the Systolic Hypertension in the Elderly Program (SHEP) trial (mean age 71 +/- 6 years) were examined by Doppler echocardiography to gain information on the cardiac structural and functional alterations in isolated systolic hypertension. Participants had a systolic blood pressure greater than 160 mm Hg with diastolic blood pressure less than 90 mm Hg and were compared with 55 age-matched normotensive control subjects. Left ventricular mass index was significantly higher in the participants than in the normotensive subjects (103 +/- 28 versus 87 +/- 23 g/m2, p = 0.0014) and 26% of the participants met echocardiographic criteria for left ventricular hypertrophy compared with 10% of normotensive subjects. Left atrial index was also greater in participants than in normotensive subjects (2.26 +/- 0.32 versus 2.11 +/- 0.24 cm/m2, p = 0.005) and 51% of participants had left atrial enlargement. Doppler measures of diastolic filling were significantly different between the two groups, with peak atrial velocity higher (76 +/- 17 versus 69 +/- 17 cm/s, p = 0.02) and ratio of peak early to atrial velocity lower (0.76 +/- 0.23 versus 0.86 +/- 0.22, p = 0.0124) in participants. There was no correlation between left ventricular mass index and Doppler measures of diastolic function, but relative wall thickness correlated significantly with peak atrial velocity (r = 0.22, p = 0.016) and peak early to peak atrial velocity ratio (r = 0.24, p = 0.007). There was no difference in M-mode ejection phase indexes of systolic performance (shortening fraction and peak velocity of circumferential fiber shortening) between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				E. Gerdts, K. Wachtell, P. Omvik, J. E. Otterstad, L. Oikarinen, K. Boman, B. Dahlof, and R. B. Devereux Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment: Losartan Intervention for Endpoint Reduction in Hypertension Trial Hypertension, February 1, 2007; 49(2): 311 - 316. [Abstract] [Full Text] [PDF]

				S. Bonapace, A. Rossi, M. Cicoira, L. Franceschini, G. Golia, L. Zanolla, P. Marino, and P. Zardini Aortic Distensibility Independently Affects Exercise Tolerance in Patients With Dilated Cardiomyopathy Circulation, April 1, 2003; 107(12): 1603 - 1608. [Abstract] [Full Text] [PDF]

				R. Pini, M. C. Cavallini, F. Bencini, G. Silvestrini, E. Tonon, W. De Alfieri, N. Marchionni, M. Di Bari, R. B. Devereux, G. Masotti, et al. Cardiovascular remodeling is greater in isolated systolic hypertension than in diastolic hypertension in older adults: the Insufficienza Cardiaca negli Anziani Residenti (ICARE) a Dicomano Study J. Am. Coll. Cardiol., October 2, 2002; 40(7): 1283 - 1289. [Abstract] [Full Text] [PDF]

				P. J.M Best, J. C Burnett Jr., S. H Wilson, D. R Holmes Jr., and A. Lerman Dendroaspis natriuretic peptide relaxes isolated human arteries and veins Cardiovasc Res, August 1, 2002; 55(2): 375 - 384. [Abstract] [Full Text] [PDF]

				E. Gerdts, L. Oikarinen, V. Palmieri, J. E. Otterstad, K. Wachtell, K. Boman, B. Dahlof, and R. B. Devereux Correlates of Left Atrial Size in Hypertensive Patients With Left Ventricular Hypertrophy: The Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study Hypertension, March 1, 2002; 39(3): 739 - 743. [Abstract] [Full Text] [PDF]

				V. Palmieri, J. N. Bella, D. K. Arnett, M. J. Roman, A. Oberman, D. W. Kitzman, P. N. Hopkins, M. Paranicas, D. C. Rao, and R. B. Devereux Aortic Root Dilatation at Sinuses of Valsalva and Aortic Regurgitation in Hypertensive and Normotensive Subjects : The Hypertension Genetic Epidemiology Network Study Hypertension, May 1, 2001; 37(5): 1229 - 1235. [Abstract] [Full Text] [PDF]

				K. J. Harjai Potential New Cardiovascular Risk Factors: Left Ventricular Hypertrophy, Homocysteine, Lipoprotein(a), Triglycerides, Oxidative Stress, and Fibrinogen Ann Intern Med, September 7, 1999; 131(5): 376 - 386. [Abstract] [Full Text] [PDF]

				J. S. Gottdiener, D. J. Reda, D. W. Williams, B. J. Materson, W. Cushman, and R. J. Anderson Effect of Single-Drug Therapy on Reduction of Left Atrial Size in Mild to Moderate Hypertension : Comparison of Six Antihypertensive Agents Circulation, July 14, 1998; 98(2): 140 - 148. [Abstract] [Full Text] [PDF]

				E. O. Ofili, J. D. Cohen, J. A. St. Vrain, A. Pearson, T. J. Martin, N. D. Uy, R. Castello, and A. J. Labovitz Effect of Treatment of Isolated Systolic Hypertension on Left Ventricular Mass JAMA, March 11, 1998; 279(10): 778 - 780. [Abstract] [Full Text] [PDF]

				S. J. Kovacs, J. Rosado, A. L. M. McGuire, and A. F. Hall Can Transmitral Doppler E-Waves Differentiate Hypertensive Hearts From Normal? Hypertension, October 1, 1997; 30(4): 788 - 795. [Abstract] [Full Text]

				W. F. Heesen, F. W. Beltman, J. F. May, A. J. Smit, P. A. de Graeff, T. K. Havinga, F. H. Schuurman, E. van der Veur, J. P.M. Hamer, B. M.-d. Jong, et al. High Prevalence of Concentric Remodeling in Elderly Individuals With Isolated Systolic Hypertension From a Population Survey Hypertension, February 1, 1997; 29(2): 539 - 543. [Abstract] [Full Text]

				M. Kim, M. J. Roman, M. C. Cavallini, J. E. Schwartz, T. G. Pickering, and R. B. Devereux Effect of Hypertension on Aortic Root Size and Prevalence of Aortic Regurgitation Hypertension, July 1, 1996; 28(1): 47 - 52. [Abstract] [Full Text]

				S. M. Vaziri, M. G. Larson, M. S. Lauer, E. J. Benjamin, and D. Levy Influence of Blood Pressure on Left Atrial Size : The Framingham Heart Study Hypertension, June 1, 1995; 25(6): 1155 - 1160. [Abstract] [Full Text]

				R. S. Vasan, M. G. Larson, and D. Levy Determinants of Echocardiographic Aortic Root Size : The Framingham Heart Study Circulation, February 1, 1995; 91(3): 734 - 740. [Abstract] [Full Text]