Ventricular Structure and Function in Hypertensive Participants With Heart Failure and a Normal Ejection FractionThe Cardiovascular Health Study
Mathew S. Maurer, MD*,
Daniel Burkhoff, MD, PhD,
Linda P. Fried, MD, MPH,
John Gottdiener, MD, FACC,
Donald L. King, MD and
Dalane W. Kitzman, MD, FACC
Clinical Cardiovascular Research Laboratory for the Elderly, Columbia University, College of Physicians and Surgeons, Allen Pavilion of New York Presbyterian Hospital, New York, New York
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Figure 1 Distribution of LVIDd
(Left) Histogram of the distribution of left ventricular internal dimensions in diastole (LVIDd) among control subjects and hypertensive subjects with a normal ejection fraction with (HFNEF) and without (HTN) heart failure. (Right) The gaussian distributions of LVIDd for the 3 cohorts (control, HTN, and HFNEF), demonstrating normal distributions with a shift in the HFNEF subjects toward larger volumes.
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Figure 2 Distribution of LVIDd Indexed to Body Surface
(Top) Histogram of the distribution of left ventricular internal dimensions in diastole (LVIDd) indexed to body surface area (BSA) among control subjects and hypertensive subjects with a normal ejection fraction with (HFNEF) and without (HTN) heart failure for men (right) and women (left). (Bottom) The gaussian distributions of LVIDd for the 3 groups (control, HTN, and HFNEF), demonstrating normal distributions with a shift in the HFNEF subjects toward larger volumes for men (right) and women (left).
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Figure 3 Distribution of LVlDd Indexed to Age, Gender, Body Size, and Race
(A) Histogram of the distribution of indexed left ventricular internal dimensions in diastole (LVIDd), which was derived for each patient by dividing the measured LVIDd and dividing it by the LVIDPredicted from the multivariate linear regression analyses multiplied by 100 among normal subjects and hypertensive subjects with a normal ejection fraction with (HFNEF) and without (HTN) heart failure. (B) The gaussian distributions of indexed LVIDd for the 3 groups (control, HTN, and HFNEF), demonstrating normal distributions with a shift in the HFNEF subjects toward larger volumes. (C) Cumulative distribution of control, HTN, and HFNEF participants by LVIDPredicted, which shows a rightward shift in the curve, indicating that for a majority of the HFNEF cohort, ventricular size is increased a small but significant amount compared with HTN and healthy control subjects.
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Figure 4 EDVI, SVI, and CI by Gender and Race in the Cohorts Studied
Calculated end-diastolic volume index (EDVI), stroke volume index (SVI), and cardiac index (CI) in healthy control subjects and hypertensive subjects with a normal ejection fraction with (HFNEF) and without (HTN) heart failure by gender and race (European [Whites] and African Americans). In all groups, average calculated left ventricular volumes and cardiac output were larger in HFNEF subjects than in control and HTN subjects.
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