Association of left bundle branch block with new onset abnormal wall motion in treated hypertensive patients with left ventricle hypertrophy: the LIFE Echo Sub-study

Abstract

Aims We aimed to investigate whether left bundle branch block (LBBB) is related to newonset left ventricle (LV) wall motion abnormalities during treatment in hypertensive patients with electrocardiogram (ECG) defined left ventricular hypertrophy (LVH). Methods and results 960 patients with essential hypertension and ECG-LVH participating in the LIFE Echo Sub-study were investigated at baseline and annually with echocardiography, during randomized antihypertensive therapy. After excluding patients with LV wall motion abnormalities at baseline and patients developing new-onset LBBB during study time, we investigated 784 patients. The participants with (n=32) and without (n=752) LBBB were similar regarding most baseline variables. Logistic regression models controlling for LV mass index, Framingham risk score, and randomized treatment assignment were used to assess the odds ratio of developing new-onset abnormal LV wall motion on annual follow-up echocardiograms. The likelihood of developing new global LV wall motion abnormalities in patients with LBBB was not higher compared to those without LBBB except at year 5 (p=0.002). The likelihood of developing new segmental LV wall motion abnormalities in patients with LBBB was however higher compared to patients without LBBB after 1 year (OR=3.

Plasma metanephrins are associated with myocardial hypertrophy and cardiac diastolic function in patients with essential hypertension

“…Standard methods were used to calculate LV systolic fractional shortening and ejection fraction [15]. Left ventricular mass (LVM) was calculated from end-diastolic LV measurements by an anatomically validated formula: LVM = (0.8 x [1.04x 9 (LVIDD + IVSTD+LVPWD) 3 -LVIDD 3 ] + 0.6 g. The LVMI was calculated by dividing the LVM by the subject's body surface area (BSA) and was derived with normal limits defined as 125 g/m 2 for men and 110 g/m 2 for women [16].…”