Abstract
Objective: It has been reported that the cardiovascular autonomic neuropathy (CAN) is present in patients with heart failure. But the relation between CAN and left ventricular (LV) diastolic function in asymptomatic patients has not been clearly elucidated. The aim of this study was to evaluate the relationship between CAN and LV diastolic function in asymptomatic hypertensive patients. Design and Method: 98 patients (F/M = 74/24, mean age = 57.3 ± 9 years old) from the KoRean wOmen'S chest pain rEgistry (KoROSE) study with hypertension were enrolled. All patients underwent TET and echocardiography. Autonomic dysfunction were evaluated by heart rate recovery (HRR: Maximal HR during exercise-HR at 3minute after exercise termination) and blood pressure response (BPR: SBP at 3minute after exercise termination / Maximal SBP during exercise). The definition of left ventricular hypertrophy was defined as >115 g/m2 for male and >95 g/m2 for female. Patients with mitral annular tissue velocity (e’)<8 cm/sec were categorized as patients with diastolic dysfunction (DD). Results: The patient with DD was 76 patients (77.6%). Exercise capacity was decreased in hypertensive patients with DD (10.0 ± 2.8 vs 11.6 ± 2.4 METs, P = 0.017). We divided the patients into 4 groups as hypertension only (n = 19), hypertension with LVH (n = 3), hypertension with DD (n = 46) and hypertension with LVH and presence of DD (n = 30). HRR and BPR were progressively impaired according to the presence of LVH and DD (Table 1). Conclusions: In hypertensive patients, the presence of DD was associated with cardiac autonomic dysfunction and was related with diminished exercise tolerance even in asymptomatic patients.
Published Version
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