Left ventricular diastolic function in hypertension: relation to left ventricular mass and systolic function

Initial studies of diastolic cardiac function in hypertension demonstrated that slowing of the maximal rate of left ventricular filling occurred before alterations in either ejection fraction or cardiac output. The present study was undertaken to determine: 1) the relation between hypertension, increased left ventricular mass and impaired left ventricular filling, and 2) the correlation between abnormalities in left ventricular diastolic function and its systolic performance. Eleven normal subjects (Group 1), 5 hypertensive patients without evidence of left ventricular hypertrophy (Group 2) and 18 hypertensive patients with increased left ventricular mass by echocardiography (Group 3) were studied by M-mode echocardiography, radionuclide (technetium-99m human serum albumin) first pass technique and gated blood pool scintigraphy. Indexes of systolic function (ejection fraction, maximal rate of ejection and percent left ventricular shortening) were essentially similar in hypertensive and normotensive subjects. No correlation was found between systolic blood pressure and left ventricular mass (r = 0.20, not significant). Maximal rate of left ventricular filling (P dV/dt) and fast filling fraction decreased progressively from Group 1 to Group 3 (2.36 +/- 0.4 [mean +/- standard deviation], 2.17 +/- 0.3 and 1.97 +/- 0.4 s-1, respectively, for P dV/dt and 46 +/- 7, 48 +/- 9 and 38 +/- 11%, respectively, for fast filling fraction); the difference from values in normal subjects reached statistical significance in hypertensive patients with left ventricular hypertrophy. Left ventricular maximal filling rate correlated inversely with left ventricular mass and left ventricular end-systolic diameter (r = -0.74), but positively with left ventricular fractional shortening and ejection fraction (r = 0.70).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				H. Pavlopoulos and P. Nihoyannopoulos Left atrial size: a structural expression of abnormal left ventricular segmental relaxation evaluated by strain echocardiography Eur J Echocardiogr, October 1, 2009; 10(7): 865 - 871. [Abstract] [Full Text] [PDF]

				H. Pavlopoulos, J. Grapsa, E. Stefanadi, V. Kamperidis, E. Philippou, D. Dawson, and P. Nihoyannopoulos The evolution of diastolic dysfunction in the hypertensive disease Eur J Echocardiogr, November 1, 2008; 9(6): 772 - 778. [Abstract] [Full Text] [PDF]

				G. de Simone, D. W. Kitzman, M. Chinali, A. Oberman, P. N. Hopkins, D. C. Rao, D. K. Arnett, and R. B. Devereux Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study Eur. Heart J., May 2, 2005; 26(10): 1039 - 1045. [Abstract] [Full Text] [PDF]

				D. Goyal, R. J. Macfadyen, R. D. Watson, and G. Y.H. Lip Ambulatory blood pressure monitoring in heart failure: a systematic review Eur J Heart Fail, March 2, 2005; 7(2): 149 - 156. [Abstract] [Full Text] [PDF]

				P. S. Villars, S. K. Hamlin, A. D. Shaw, and J. T. Kanusky Role of Diastole in Left Ventricular Function, I: Biochemical and Biomechanical Events Am. J. Crit. Care., September 1, 2004; 13(5): 394 - 403. [Abstract] [Full Text] [PDF]

				R. S. Vasan, E. J. Benjamin, M. G. Larson, E. P. Leip, T. J. Wang, P. W. F. Wilson, and D. Levy Plasma Natriuretic Peptides for Community Screening for Left Ventricular Hypertrophy and Systolic Dysfunction: The Framingham Heart Study JAMA, September 11, 2002; 288(10): 1252 - 1259. [Abstract] [Full Text] [PDF]

				G. Schillaci, L. Pasqualini, P. Verdecchia, G. Vaudo, S. Marchesi, C. Porcellati, G. de Simone, and E. Mannarino Prognostic significance of left ventricular diastolic dysfunction in essential hypertension J. Am. Coll. Cardiol., June 19, 2002; 39(12): 2005 - 2011. [Abstract] [Full Text] [PDF]

				J. N. Bella, V. Palmieri, J. E. Liu, D. W. Kitzman, A. Oberman, S. C. Hunt, P. N. Hopkins, D.C. Rao, D. K. Arnett, and R. B. Devereux Relationship Between Left Ventricular Diastolic Relaxation and Systolic Function in Hypertension: The Hypertension Genetic Epidemiology Network (HyperGEN) Study Hypertension, September 1, 2001; 38(3): 424 - 428. [Abstract] [Full Text] [PDF]

				B. M. Pluim, A. H. Zwinderman, A. van der Laarse, and E. E. van der Wall The Athlete’s Heart : A Meta-Analysis of Cardiac Structure and Function Circulation, January 25, 2000; 101(3): 336 - 344. [Abstract] [Full Text] [PDF]

				A. M. Grandi, P. Zanzi, A. Fachinetti, G. Gaudio, L. Ceriani, A. Bertolini, L. Guasti, and A. Venco Insulin and Diastolic Dysfunction in Lean and Obese Hypertensives : Genetic Influence Hypertension, December 1, 1999; 34(6): 1208 - 1214. [Abstract] [Full Text] [PDF]

				M. G. Modena, N. Muia Jr, P. Aveta, R. Molinari, and R. Rossi Effects of Transdermal 17{beta}-Estradiol on Left Ventricular Anatomy and Performance in Hypertensive Women Hypertension, November 1, 1999; 34(5): 1041 - 1046. [Abstract] [Full Text] [PDF]

				H. J. Lamb, H. P. Beyerbacht, A. van der Laarse, B. C. Stoel, J. Doornbos, E. E. van der Wall, and A. de Roos Diastolic Dysfunction in Hypertensive Heart Disease Is Associated With Altered Myocardial Metabolism Circulation, May 4, 1999; 99(17): 2261 - 2267. [Abstract] [Full Text] [PDF]

				C. C. de Cock, L. M. C. van Campen, O. Kamp, and C. A. Visser Pacing-induced left ventricular dysfunction: Relationship with coronary perfusion Europace, January 1, 1999; 1(2): 146 - 147. [Abstract] [PDF]

				K. Wong, K. R. Boheler, M. Petrou, and M. H. Yacoub Pharmacological Modulation of Pressure-Overload Cardiac Hypertrophy : Changes in Ventricular Function, Extracellular Matrix, and Gene Expression Circulation, October 7, 1997; 96(7): 2239 - 2246. [Abstract] [Full Text]

				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]

				G. R. Norton, J. Tsotetsi, B. Trifunovic, C. Hartford, G. P. Candy, and A. J. Woodiwiss Myocardial Stiffness Is Attributed to Alterations in Cross-Linked Collagen Rather Than Total Collagen or Phenotypes in Spontaneously Hypertensive Rats Circulation, September 16, 1997; 96(6): 1991 - 1998. [Abstract] [Full Text]

				G. P. Rossi, A. Sacchetto, E. Pavan, P. Palatini, G. R. Graniero, C. Canali, and A. C. Pessina Remodeling of the Left Ventricle in Primary Aldosteronism Due to Conn's Adenoma Circulation, March 18, 1997; 95(6): 1471 - 1478. [Abstract] [Full Text]

				J. Karjalainen, M. Mantysaari, M. Viitasalo, and U. Kujala Left ventricular mass, geometry, and filling in endurance athletes: association with exercise blood pressure J Appl Physiol, February 1, 1997; 82(2): 531 - 537. [Abstract] [Full Text] [PDF]

				G. F. Mureddu, G. de Simone, R. Greco, G. F. Rosato, and F. Contaldo Left Ventricular Filling in Arterial Hypertension: Influence of Obesity and Hemodynamic and Structural Confounders Hypertension, February 1, 1997; 29(2): 544 - 550. [Abstract] [Full Text]

				R. S. Vasan and D. Levy The Role of Hypertension in the Pathogenesis of Heart Failure: A Clinical Mechanistic Overview Arch Intern Med, September 9, 1996; 156(16): 1789 - 1796. [Abstract] [PDF]

				T. Nishikimi, F. Yoshihara, A. Morimoto, K. Ishikawa, T. Ishimitsu, Y. Saito, K. Kangawa, H. Matsuo, T. Omae, and H. Matsuoka Relationship Between Left Ventricular Geometry and Natriuretic Peptide Levels in Essential Hypertension Hypertension, July 1, 1996; 28(1): 22 - 30. [Abstract] [Full Text]

				G. P. Rossi, A. Sacchetto, P. Visentin, C. Canali, G. R. Graniero, P. Palatini, and A. C. Pessina Changes in Left Ventricular Anatomy and Function in Hypertension and Primary Aldosteronism Hypertension, May 1, 1996; 27(5): 1039 - 1045. [Abstract] [Full Text]

				R. S. Vasan, E. J. Benjamin, and D. Levy Congestive Heart Failure With Normal Left Ventricular Systolic Function: Clinical Approaches to the Diagnosis and Treatment of Diastolic Heart Failure Arch Intern Med, January 22, 1996; 156(2): 146 - 157. [Abstract] [PDF]

				B. L. Zaret and F. J. Wackers Nuclear Cardiology- Second of Two Parts N. Engl. J. Med., September 16, 1993; 329(12): 855 - 863. [Full Text]

				R. O. Bonow and J. E. Udelson Left Ventricular Diastolic Dysfunction as a Cause of Congestive Heart Failure: Mechanisms and Management Ann Intern Med, September 15, 1992; 117(6): 502 - 510. [Abstract] [PDF]

				J. DeCree, P. Van Rooy, H. Geukens, K. Haeverans, and H. Verhaegen The Antihypertensive and Cardiac Hemodynamic Effects of Nebivolol Angiology, May 1, 1992; 43(5): 369 - 377. [Abstract] [PDF]

				P. Spirito and B. J. Maron Doppler Echocardiography for Assessing Left Ventricular Diastolic Function Ann Intern Med, July 15, 1988; 109(2): 122 - 126. [Abstract] [PDF]

				R. M. LANG, S. K. FELLNER, A. NEUMANN, D. A. BUSHINSKY, and K. M. BOROW Left Ventricular Contractility Varies Directly with Blood Ionized Calcium Ann Intern Med, April 1, 1988; 108(4): 524 - 529. [Abstract] [PDF]

				R. C. Harizi, J. A. Bianco, and J. S. Alpert Diastolic Function of the Heart in Clinical Cardiology Arch Intern Med, January 1, 1988; 148(1): 99 - 109. [Abstract] [PDF]

				R. M. LANG, K. M. BOROW, A. NEUMANN, and T. FELDMAN Adverse Cardiac Effects of Acute Alcohol Ingestion in Young Adults Ann Intern Med, June 1, 1985; 102(6): 742 - 747. [Abstract] [PDF]