Relation of left ventricular geometry and function to aortic root dilatation in patients with systemic hypertension and left ventricular hypertrophy (the LIFE study)

Abstract

Echocardiographically detemined left ventricular (LV) hypertrophy is an independent predictor of increased cardiovascular morbidity and mortality in hypertensive patients. 1 Casale P.N Devereux R.B Milner M Zullo G Harshfeld G.A Pickering T.G Laragh J.H Value of echocardiographic assessment of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. Ann Intern Med. 1986; 105: 173-178 Crossref PubMed Scopus (1034) Google Scholar , 2 Koren M.J Devereux R.B Casale P.N Savage D.D Laragh J.H Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med. 1991; 114: 345-352 Crossref PubMed Scopus (2160) Google Scholar Recent reports have described associations between LV geometric adaptation and extracardiac target organ damage in essential hypertension, with hypertensive patients with concentric LV geometry having the most advanced fundoscopic abnormalities, the greatest renal dysfunction, 3 Shigematsu Y Hamada M Mukai M Matsuoka H Sumimoto T Hiwada K Clinical evidence for an association between left ventricular geometric adaptation and extracardiac target organ damage in essential hypertension. J Hypertens. 1995; 13: 155-160 Crossref PubMed Scopus (92) Google Scholar and the most severe abnormalities of carotid artery structure and function. 4 Roman M.J Pickering T.G Schwartz J.E Pini R Devereux R.B Relation of arterial structure and function to left ventricular geometric patterns in hypertensive adults. J Am Coll Cardiol. 1996; 28: 751-756 Abstract Full Text PDF PubMed Google Scholar , 5 Bella J.N Roman M.J Pini R Shwartz J.E Pickering T.G Devereux R.B Assessment of arterial compliance by carotid midwall strain-stress relation in hypertension. Hypertension. 1999; 33: 793-799 Crossref PubMed Scopus (13) Google Scholar However, although geometric and functional abnormalities of medium-sized capacitance arteries associated with LV hypertrophy have been identified in relatively mild, uncomplicated hypertension, 4 Roman M.J Pickering T.G Schwartz J.E Pini R Devereux R.B Relation of arterial structure and function to left ventricular geometric patterns in hypertensive adults. J Am Coll Cardiol. 1996; 28: 751-756 Abstract Full Text PDF PubMed Google Scholar , 5 Bella J.N Roman M.J Pini R Shwartz J.E Pickering T.G Devereux R.B Assessment of arterial compliance by carotid midwall strain-stress relation in hypertension. Hypertension. 1999; 33: 793-799 Crossref PubMed Scopus (13) Google Scholar relations of the size of the most proximal portion of the systemic arterial tree (the aortic root) to LV geometry and function have not been elucidated in patients with more severe hypertension. Therefore, the purpose of the present study was to identify the clinical and echocardiographic characteristics of hypertensive patients with aortic root dilatation and to examine the relation of cardiac geometry and function to aortic size in hypertensive participants enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy.