Exaggerated exercise blood pressure response is related to tissue Doppler imaging estimated diastolic dysfunction in the early stages of hypertension

Tsioufis, Costas; Chatzis, Dimitrios; Tsiachris, Dimitris; Katsi, V.; Toutouzas, Kostas; Tousoulis, Dimitris; Vlasseros, I.; Stefanadis, Christodoulos; Kallikazaros, Ioannis

doi:10.1016/j.jash.2007.11.002

Cited by 10 publications

(17 citation statements)

References 21 publications

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“…Studies conducted on hypertensive patients demonstrated a direct relationship between the degree of LVH and impairment of diastolic filling. 29) Tsioufis, et al 12) demonstrated that compared to their counterparts without EBPR, hypertensives with EBPR were characterized by more pronounced LV diastolic dysfunction assessed by TDI. In our HTN subjects, however, no statistically significant difference was noticed in LV diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Our results are consistent with previous studies. [13][14][15] In addition, Tsioufis, et al 12) demonstrated that hypertensives with EBPR compared to their counterparts without EBPR are characterized by more pronounced LV diastolic dysfunction (Em/Am), which was related with ambulatory PP. Trika, et al 16) revealed that in elderly hypertensive patients without LVH, a large PP at night may serve as an independent predictor of abnormal LV diastolic filling (E/A).…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] In addition, diastolic dysfunction of the LV frequently accompanies EBPR. 12) However, we do not know whether EBPR in athletes would show the same features associated with abnormal LV remodeling and diastolic dysfunction. Recently, we have unofficially found numerous cases of EBPR to exercise in Korean nonathletic marathon runners.…”

mentioning

confidence: 93%

“…It is well known that PP is associated with LVH [13][14][15] and diastolic dysfunction. 12,16) Increased ET-1 production has unfavorable effects on the arterial walls, 17) and endothelial dysfunction is related to the LVH and diastolic function. [18][19][20] Echocardiographic techniques have been proposed to study structural and functional changes of the myocardium in athlete hearts and to distinguish physiological from pathological hypertrophy.…”

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confidence: 99%

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Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

et al. 2013

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SummaryThis study was conducted to study left ventricular hypertrophy (LVH), diastolic dysfunction, pulse pressure (PP), and plasma endothelin (ET)-1 level in amateur marathon runners with an exaggerated blood pressure response (EBPR) to exercise. The study participants included normotensive marathon runners (NM, n = 15), EBPR marathon runners (EBPR, n = 17), normotensive sedentary individuals (CON, n = 13), and hypertensive patients (HTN, n = 14). An integrated M-mode/2-dimensional echocardiographic analysis was performed. Plasma ET-1 levels at resting were measured using a commercial ELISA kit. LV wall thickness and end-diastolic dimensions as well as LV mass index (LVMI) were higher in EBPR than in CON. There were no differences in systolic function among the groups. Analysis of diastolic function, such as lower Em and higher E/Em ratio on TDI, showed a worse relaxation pattern in EBPR. Despite LVH, NM subjects showed no abnormality of LV diastolic dysfunction. HTN subjects in the early stage of their disease showed a slightly modified LV structural and diastolic function, but there was no statistical difference compared with CON. The E/Em ratio was significantly correlated with PP and LVMI. LVMI was significantly correlated with PP. There was a significant difference in plasma ET-1 concentration between marathon runners and hypertensive subjects. We demonstrated that marathon runners with EBPR showed an increase in LVMI and diastolic dysfunction more than HTN subjects in the early stage. PP was significantly related to these two variables. Caution should be exercised when connecting LVH and diastolic dysfunction with plasma ET-1 concentration in all marathon runners. (Int Heart J 2013; 54: 82-87)Key words: Endothelin-1, Marathon A thlete's heart is a well known condition characterized by structural, electrical, and functional adaptations of the myocardium consequent to regular physical training and consistent with the intensity, duration, and type of activity.1,2) To date, conflicting data have been reported concerning the nature (physiologic versus pathologic) of left ventricular hypertrophy (LVH) in master athletes and veterans. [3][4][5][6] Exaggerated blood pressure response (EBPR) during exercise is associated with increased risk of worsening hypertension in normotensives, as well as in subjects with high normal blood pressure (BP). 7,8) Moreover, EBPR might be related to adverse cardiovascular outcomes, partially due to its association with indices of target-organ damage such as LVH, abnormal geometry, or carotid atherosclerosis. [9][10][11] In addition, diastolic dysfunction of the LV frequently accompanies EBPR. 12)However, we do not know whether EBPR in athletes would show the same features associated with abnormal LV remodeling and diastolic dysfunction. Recently, we have unofficially found numerous cases of EBPR to exercise in Korean nonathletic marathon runners. Marathons have become a popular leisure activity in Korea during the last 2 decades and rank first in popularity as a public sport. We t...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

mentioning

confidence: 99%

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Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

et al. 2013

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“…In the context of essential hypertension, we have earlier exhibited an association between EBPR status with LV mass index, diastolic dysfunction, urinary albumin excretion, and aortic stiffness [10][11]. Although the gold standard method for the evaluation of the latter is the measurement of carotid-femoral pulse wave velocity (PWV), in recent years ambulatory arterial stiffness index (AASI) has also been proposed as an emerging marker [12].…”

Section: Introductionmentioning

confidence: 99%

Relationship of ambulatory arterial stiffness index with blood pressure response to exercise in the early stages of hypertension

Tsiachris

Tsioufis²,

Dimitriadis³

et al. 2010

Blood Pressure Monitoring

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Relation of Impaired Coronary Microcirculation to Increased Urine Albumin Excretion in Patients With Systemic Hypertension and No Epicardial Coronary Arterial Narrowing

Tsiachris

Tsioufis

Dimitriadis

et al. 2012

The American Journal of Cardiology

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Exaggerated exercise blood pressure response is related to tissue Doppler imaging estimated diastolic dysfunction in the early stages of hypertension

Cited by 10 publications

References 21 publications

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

Left Ventricular Hypertrophy, Diastolic Dysfunction, Pulse Pressure, and Plasma ET-1 in Marathon Runners With Exaggerated Blood Pressure Response

Relationship of ambulatory arterial stiffness index with blood pressure response to exercise in the early stages of hypertension

Relation of Impaired Coronary Microcirculation to Increased Urine Albumin Excretion in Patients With Systemic Hypertension and No Epicardial Coronary Arterial Narrowing

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