Prognostic significance of left ventricular diastolic dysfunction in essential hypertension

Schillaci, Giuseppe; Pasqualini, Leonella; Verdecchia, Paolo; Vaudo, Gaetano; Marchesi, Simona; Porcellati, Carlo; Simone, Giovanni de; Mannarino, Elmo

doi:10.1016/s0735-1097(02)01896-x

Cited by 248 publications

(167 citation statements)

References 33 publications

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“…[3][4][5][6] Patients with chronic heart failure due to LV diastolic dysfunction have apparent preservation of systolic function, defined by an ejection fraction X50%. 7,8 Such patients are typically obese females, and they often have a history of chronic hypertension and LV hypertrophy.…”

Section: Introductionmentioning

confidence: 99%

Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients

et al. 2011

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Although visit-to-visit variability in systolic blood pressure (SBP) has recently been demonstrated to be a strong predictor of stroke, there are no data about relationships between SBP variability and cardiac damage in hypertensive patients. We compared relationships between visit-to-visit variability in SBP and left ventricular (LV) diastolic dysfunction with the relationships between the mean SBP value and cardiac parameters in treated patients. Forty treated hypertensive patients (69±9 years of age) had their blood pressure measured at outpatient clinics every 1 or 2 months over a 1-year period. The standard deviation (s.d.) of SBP and the difference between the maximum and minimum SBPs during this year were calculated to assess visit-to-visit variability. The mean SBP during the year was also calculated. LV diastolic function was assessed by the ratio (E/A) of early (E) and late (A) diastolic transmitral flows, early diastolic mitral annular velocity (e¢) and the ratio (E/e¢) of E to e¢ using Doppler echocardiography. E/A only correlated with the s.d. of SBP (r¼À0.327, P¼0.040), whereas e¢ correlated with s.d. of SBP (r¼À0.496, P¼0.001) and maximum-minimum SBP difference (r¼À0.490, P¼0.001). E/e¢ correlated with s.d. of SBP (r¼0.384, P¼0.014), maximum-minimum SBP difference (r¼0.410, P¼0.009), and the mean value of SBP (r¼0.349, P¼0.028). Multiple regression analysis demonstrated only the maximum-minimum SBP difference independently associated with E/e¢ (b¼0.410, P¼0.009). Thus, the visit-to-visit variability of SBP showed better correlation with LV diastolic dysfunction than mean values of SBP. High visit-to-visit variability of SBP was associated with LV diastolic dysfunction and may constitute a high risk for diastolic heart failure in hypertensive patients.

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Section: Introductionmentioning

confidence: 99%

Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients

et al. 2011

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“…3,4 LV diastolic dysfunction is common in hypertensive patients and it strongly predicts cardiovascular morbidity and overall mortality in hypertensive patients. 5,6 Salusins are newly identified bioactive peptides discovered by bioinformatics analysis of a fulllength complememtary DNA library. 7 Shichiri et al 7 recently characterized two related peptides of 28 and 20 amino acids designated salusin-alpha and salusin-beta, respectively.…”

Section: Introductionmentioning

confidence: 99%

Associations of serum salusin-alpha levels with atherosclerosis and left ventricular diastolic dysfunction in essential hypertension

Wang

et al. 2011

J Hum Hypertens

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Serum salusin-alpha, is decreased in essential hypertension and acute coronary syndrome. The study is aimed to explore whether serum salusin-alpha is associated with atherosclerosis and left ventricular (LV) diastolic dysfunction in essential hypertension. Echocardiography, carotid ultrasonography, brachial-ankle pulse wave velocity (BaPWV) and serum salusin-alpha levels were determined in 60 hypertensive patients (29 with and 31 without carotid plaque) and 30 normotensive controls. Hypertensive patients with plaque, compared with those without plaque or the controls, had the lowest values of salusin-alpha. Then the hypertensive patients were divided into left ventricular hypertrophy (LVH) and non-LVH groups according to the echocardiography. Similarly, hypertensive patients with LVH showed the lowest serum salusinalpha levels. In all subjects, serum salusin-alpha levels were negatively correlated with carotid mean-intimamedia thickness (IMT), BaPWV, left ventricle mass index (LVMI) and E/E 0 (r ¼ À0.488, Po0.001; r ¼ À0.381, Po0.001; r ¼ À0.294, P ¼ 0.006; r ¼ À0.303, P ¼ 0.005; respectively). Serum salusin-alpha levels were independent predictors of BaPWV, carotid strain, carotid distensibility, mean-IMT, LVMI and E 0 /A 0 (b ¼ À0.399, 0.283, 0.237, À0.346, À0.306, 0.469; P ¼ 0.002, 0.031, 0.016, 0.005, 0.012 and 0.001, respectively) in multiple linear regression models. These results suggest that serum salusin-alpha may be associated with atherosclerosis and LV diastolic dysfunction in essential hypertension.

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“…Impaired long axis contraction of the left ventricle may also be associated with increased mortality [16]. Furthermore, the presence of left ventricular diastolic filling abnormalities has been demonstrated to place an individual at increased cardiovascular risk [17,18] and is associated with impaired exercise tolerance [19]. We sought to determine the prevalence of these potentially modifiable left ventricular abnormalities, namely LVH, LVSD, left ventricular long axis contraction and diastolic filling abnormalities, in a cohort of 500 type 2 diabetic subjects.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of left ventricular hypertrophy in type 2 diabetes mellitus

2005

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Aims/hypothesis: Patients with type 2 diabetes mellitus are at greater cardiovascular risk than the general population. Although it is widely acknowledged that diabetes is a risk factor for coronary artery disease, the increased prevalence of potentially lethal left ventricular abnormalities in this population is less well appreciated. Methods: We carried out an echocardiographic study of 500 subjects with type 2 diabetes mellitus to assess the prevalence of left ventricular hypertrophy (LVH) and left ventricular systolic dysfunction (LVSD). We also assessed whether abnormalities in diastolic filling parameters were present. Results: Of the 371 patients in whom left ventricular mass could be successfully assessed, 264 had LVH (71%). Left ventricular systolic dysfunction was much less common, being present in 16/385 patients (4.2%). Long axis contraction was abnormal in 29/429 patients (6.8%). Diastolic filling abnormalities were present in 178/435 (41%) of patients who could be classified using the selected criteria. Conclusions: We conclude that left ventricular abnormalities are common in type 2 diabetic patients. As medical therapy is available for both LVH and LVSD and has been demonstrated to reduce cardiovascular death, these left ventricular abnormalities could be ideal targets for screening, followed by selective therapeutic intervention.

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Prognostic significance of left ventricular diastolic dysfunction in essential hypertension

Abstract: Impaired LV early diastolic relaxation, detected by pulsed Doppler echocardiography, identifies hypertensive patients at increased cardiovascular risk. Such association is independent of LV mass and ambulatory BP.

Cited by 248 publications

References 33 publications

Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients

Visit-to-visit variability in blood pressure over a 1-year period is a marker of left ventricular diastolic dysfunction in treated hypertensive patients

Associations of serum salusin-alpha levels with atherosclerosis and left ventricular diastolic dysfunction in essential hypertension

The epidemiology of left ventricular hypertrophy in type 2 diabetes mellitus

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