Left Ventricle Geometric Patterns Research Articles

Cardiac remodeling after anthracycline and radiotherapy exposure in adult survivors of childhood cancer: A report from the St Jude Lifetime Cohort Study.

Limited data exist regarding left ventricular remodeling patterns observed in adult survivors of childhood cancer after therapy. Among 1190 adult survivors diagnosed with childhood cancer (median age at diagnosis, 9 years [interquartile range (IQR), 3.8-14.4 years]; age at evaluation, 35.6 years [IQR, 29.5-42.8 years]), treatment exposures included anthracyclines (n = 346), chest radiotherapy (n = 174), both (n = 245), or neither (n = 425). Prospective echocardiographic assessment compared survivors with 449 noncancer controls classified according to left ventricle geometric patterns. Associations between left ventricle geometric patterns and decreased exercise tolerance were assessed. Overall, 28.2% of survivors (95% confidence interval [CI], 25.6%-30.8%) exhibited concentric remodeling, 2.4% (95% CI, 1.6%-3.5%) exhibited eccentric hypertrophy, and 1.1% (95% CI, 0.6%-1.9%) exhibited concentric hypertrophy. A greater proportion of survivors who received only chest radiotherapy (41%) had concentric remodeling compared with those who received only anthracyclines (24%), both (27%), or neither (27%; all P < .001), and all were greater than the proportions in noncancer controls (18%; all P < .05). Concentric remodeling was associated with radiation exposure, but not with anthracycline exposure, in multivariable models. Survivors who had concentric remodeling were more likely to have a maximal oxygen uptake peak <85% compared with those who had normal geometry (81.0% vs 66.3%; odds ratio, 1.75; 95% CI, 1.15-2.68). Chest radiation therapy, but not anthracycline therapy, increased the risk for concentric remodeling in survivors of childhood cancer. The presence of concentric remodeling was associated with increased exercise intolerance.

Modified Cornell electrocardiographic criteria in the assessment of left ventricular hypertrophy geometry of patients with essential hypertension.

To evaluate the value of modified Cornell electrocardiographic criteria in the assessment of left ventricular hypertrophy (LVH) for patients with essential hypertension. A total of 381 patients with essential hypertension diagnosed in our hospital were selected. Using the left ventricle (LV) geometric patterns classified by the American Society of Echocardiography (ASE), we examined the distribution of the modified Cornell criteria of Ravl + SD (the deepest S wave in 12‐lead ECG) in different geometric patterns and analyzed the correlation of modified Cornell criteria with changes in the LV geometric patterns using multiple linear regression analysis. The distribution of modified Cornell criteria, Sokolow‐Lyon criteria (RV5/V6 + SV1), and Cornell criteria (Ravl + SV3) in gender‐specific hypertensive geometric patterns were significantly different (P ≤ .01 for all). The voltage of Ravl + SD in male patients showed an increase trend in the normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) groups, and this increase trend was significantly in the unadjusted model and the adjusted model. The voltages of Ravl + SV3 and RV5/V6 + SV1 of male patients in CR, CH and RH groups showed a gradual increase trend, but the increase trend in CR group has no statistical significance compared to that in NG group (P ≥ .05). The voltages of Ravl + SD, RV5/V6 + SV1, and Ravl + SV3 in female patients in CR, CH and EH groups showed a trend of increase after decrease in the adjusted model. In conclusion, the modified Cornell criteria could dynamically reflect left ventricular hypertensive geometry of male patients.

Epicardial Fat Thickness is Associated with Abnormal Left Ventricle Geometry in Newly Diagnosed Hypertension.

Epicardial adipose tissue is an emerging cardio metabolic risk factor. Although an association between epicardial fat thickness (EFT) and left ventricle (LV) hypertrophy in hypertensive patients is known, the relationship between abnormal LV geometric patterns and EFT has yet to be investigated. The aim of the present study was to investigate the relationship between EFT and abnormal LV geometric patterns in hypertensive patients. Measurements were obtained from 343 patients with untreated essential hypertension (mean age 51.6 ± 5.5 years) and 52 healthy control subjects (mean age 51.8 ± 4.5 years). Four different geometric patterns (NG; normal geometry, CR; concentric remodeling, EH; eccentric hypertrophy, and CH; concentric hypertrophy) were determined according to LV mass index (LVMI) and relative wall thickness (RWt). EFT was measured using transthoracic echocardiography. High sensitive C-reactive protein (hs-CRP) and other biochemical markers were measured in all participants. The highest EFT and hs-CRP values were determined in the CH group (EFT = 8.9 ± 2.1 mm) compared with the controls (EFT = 5.7 ± 1.5 mm), followed by the NG (EFT = 5.9 ± 1.6 mm), CR (EFT = 5.9 ± 1.3 mm) and EH groups (EFT = 6.5 ± 1.6 mm) (all p < 0.05). In addition, the EFT values of the EH group were higher than the control, NG and CR groups (all p < 0.05). Multivariate linear regression analysis showed that EFT was independently associated with LV geometry (β = 0.161, p = 0.032), total cholesterol level (β = -0.129, p = 0.003), triglyceride level (β = 0.266, p < 0.001), hs-CRP level (β = 0.349, p < 0.001), and creatinine level (β = 0.108, p = 0.010). EFT is independently associated with abnormal LV geometry, LV hypertrophy, creatinine level, and low grade chronic inflammation.

Epicardial Fat Thickness is Associated with Abnormal Left Ventricle Geometry in Newly Diagnosed Hypertension.

Epicardial adipose tissue is an emerging cardio metabolic risk factor. Although an association between epicardial fat thickness (EFT) and left ventricle (LV) hypertrophy in hypertensive patients is known, the relationship between abnormal LV geometric patterns and EFT has yet to be investigated. The aim of the present study was to investigate the relationship between EFT and abnormal LV geometric patterns in hypertensive patients.Measurements were obtained from 343 patients with untreated essential hypertension (mean age 51.6 ± 5.5 years) and 52 healthy control subjects (mean age 51.8 ± 4.5 years). Four different geometric patterns (NG; normal geometry, CR; concentric remodeling, EH; eccentric hypertrophy, and CH; concentric hypertrophy) were determined according to LV mass index (LVMI) and relative wall thickness (RWt). EFT was measured using transthoracic echocardiography. High sensitive C-reactive protein (hs-CRP) and other biochemical markers were measured in all participants.The highest EFT and hs-CRP values were determined in the CH group (EFT = 8.9 ± 2.1 mm) compared with the controls (EFT = 5.7 ± 1.5 mm), followed by the NG (EFT = 5.9 ± 1.6 mm), CR (EFT = 5.9 ± 1.3 mm) and EH groups (EFT = 6.5 ± 1.6 mm) (all p < 0.05). In addition, the EFT values of the EH group were higher than the control, NG and CR groups (all p < 0.05). Multivariate linear regression analysis showed that EFT was independently associated with LV geometry (β = 0.161, p = 0.032), total cholesterol level (β = -0.129, p = 0.003), triglyceride level (β = 0.266, p < 0.001), hs-CRP level (β = 0.349, p < 0.001), and creatinine level (β = 0.108, p = 0.010).EFT is independently associated with abnormal LV geometry, LV hypertrophy, creatinine level, and low grade chronic inflammation.

Prevalence and correlates of new-onset left ventricular geometric abnormalities in a general population: the PAMELA study.

We sought to evaluate new-onset abnormal LV (left ventricle) patterns and their correlates over a 10-year period in members of the general population enrolled in the Pressioni Arteriose Monitorate e Loro Associazioni study. The study included 817 patients with normal LV geometry at baseline evaluation having a readable echocardiogram at the end of follow-up. Cut-points for abnormal LV geometric patterns were derived from reference values of the healthy fraction of the Pressioni Arteriose Monitorate e Loro Associazioni population. Over a 10-year period 39% of participants progressed to abnormal LV geometric patterns as follows: LV concentric remodelling (15.2%), eccentric dilated left ventricular hypertrophy (LVH) (8.4%), concentric LVH (7.9%), eccentric nondilated LVH (6.8%), and concentric dilated LVH (0.7%). Age [odds ratio (OR): 1.039; 95% confidence interval (CI) 1.023-1.056, P < 0.0001], LV mass index (OR: 1.039; 95% CI 1.026-1.052, P < 0.0001), night-time SBP (OR: 1.024; 95% CI 1.005-1.043, P = 0.01), office SBP changes during follow-up (OR: 1.017 95% CI 1.007-1028, P = 0.001), and BMI (OR: 1.067; 95% CI 1.017-1.120, P = 0.009) emerged as key correlates of new-onset abnormal LV geometry. Age and LV mass index turned out to be strong determinants of all sub-types of LVH; whereas blood pressure, BMI, and sex exhibited a different predictive value across the various LV geometric patterns. Our study provides the first evidence that long-term changes from normal cardiac morphology toward abnormal LV geometry represent a clinically relevant phenomenon at the community level. From a practical perspective this finding reinforces the concept that life-style changes and pharmacologic treatment aimed to reduce over-weight/obesity and optimize blood pressure are of paramount importance for prevention of subclinical cardiac damage.

Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up.

BackgroundCatheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).Methods and ResultsFrom a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65±7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176±24 to 149±13mmHg, p<0.001) and DBP (90±14 to 79±11mmHg, p<0.001), and also in 24h ABPM SBP (150±20 to 132±14mmhg, p<0.001) and DBP (83±10 to 74±9mmHg, p<0.001). There was also a significant decrease in LV mass from 152±32 to 136±34g/m2 (p<0.001), an increase in LV end diastolic volume (93±18 to 111±27 mL, p = 0.004), an increase in LV ejection fraction (65±9 to 68±9%, p = 0.001) and mitral valve E deceleration time (225±49 to 247±51ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.ConclusionsIn this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.

THE RELATIONSHIP OF LEFT VENTRICULAR GEOMETRIC PATTERNS AND SEVERITY OF CORONARY ARTERY DISEASE IN HYPERTENSIVE STABLE ANGINA PECTORIS

Introduction: Hypertensive patients have different geometric patterns of the left ventricle (LV) with different LV function. Hypertension is well known as a risk factor of Coronary Artery Disease (CAD) that frequently cause by atherosclerosis. Severity of coronary atherosclerosis is known by Gensini score. Therefore, we investigate the relatioship between severity of CAD, assessed bygensini score, and LV geometric patterns in patients in hypertensive stable angina pectoris. Methods: Between Oktober 2014 to Desember 2014, we evaluated 32patients who had hypertensive stable angina pectoris who underwent coronary angiography. The exclusion criteria were presence of neoplastic disease, recent major surgical procedure, or chronic liver or kidney disease. Coronary lesions were calculatedusing gensini score on the baseline diagnostic angiogram. Two-dimensional echocardiographies were performed to measure LV geometric and function. Geometric patterns were based on normal geometry, eccentric hypertrophy, and concentric hypertrophy. Result: From baseline characteristic, it shows male 23 (71.9%) with age between 45 until 73 yearsold (57.28 ± 7.34), systolic blood pressure (149,90 ± 25.66),, and gensini score 5– 132 (65.28 ± 36,44). Statistical analysis was done with bivariate analysis. Gensini score was significant relation with LV Hypertrophy, but not LVMI. Discussion: Several mechanismshave been proposed like hypertension stimulates both LVH and atherosclerosis. The renin-angiotensin-aldosteronesystem can be the most important mechanism. Angiotensin IIpromotes intracellularreactions that may lead to both cardiac hypertrophy andthe progression of severity atherosclerotic lesions through theproliferation of vascular smooth muscle cells and the productionof extracellular matrix protein. LVH in hypertensivepatients leads changes in contractility, fibrotic myocytes,systolic and diastolic dysfunction, and electrical remodeling,resulting in alterations in myocardial function. Our study showgensini score were associatedwith LV geometribut not with LVMI. Conclusion: Hypertensive stable angina pectoris has both severity of coronary artery lesion and LV hypertrophy. It can be thought that ventricular remodeling in hypertensive patients may be parallel to the severity of coronary artery disease.

PP-090 Relationship between Plasma Thiol Levels with Left Ventricle Geometric Patterns and Left Ventricle Diastolic Functions in Patients with Newly Diagnosed Essential Hypertension

PP-090 Relationship between Plasma Thiol Levels with Left Ventricle Geometric Patterns and Left Ventricle Diastolic Functions in Patients with Newly Diagnosed Essential Hypertension

The relation of gender and geometry to left ventricular structure and functions in a newly presenting hypertensive population in Nigeria

Background: Studies differ on the influence of gender and geometry on the functions of left ventricle (LV). We report the relation of abnormal geometry and gender to LV structure and functions in an African population. Materials and Methods: A total of 156 consecutive newly presenting hypertensives comprising 53% females were enrolled into the study. All participants underwent full clinical evaluation, and echocardiographic examination was performed according to the American Society of echocardiography recommendation. Using LV mass index (LVMI) and relative wall thickness, 145 subjects with complete echocardiographic parameters were divided into four LV geometric patterns; normal, concentric remodelling (CR), eccentric hypertrophy, and concentric hypertrophy. Results: The mean age of the hypertensive subjects was 59.5 (12.3) years. The mean age and blood pressure (BP) indices were comparable across the gender. While males were taller, females were heavier and had wider waist and hip circumferences. Men had larger left atrium, aortic root diameter, aortic valvular opening, LV dimensions, and LVM compared with females. LV systolic and diastolic functions were similar. More than half of the subjects had abnormal geometry with CR prevalent. The subjects with concentric hypertrophy were the youngest (P = 0.036) and had the highest mean diastolic BP (P = 0.037). There was no significant gender influence on the distribution of geometry pattern. Left Atrial diameter and LV dimensions except posterior wall thickness at diastole were significantly larger in eccentric hypertrophy when compared with other groups (P = 0.0001). LV ejection fraction was lowest among subjects with eccentric hypertrophy. Diastolic function parameters were comparable among the groups. Conclusion: The study showed that more than half of the study subjects had abnormal geometry even at the presentation. Abnormal geometry probably affects LV systolic function more than the diastolic filling patterns. Prompt management may alter the prognostic effect of abnormal geometry among the study group.

Abstract 17729: Ideal Cardiovascular Health is Associated With a Lower Prevalence of Adverse Left Ventricular Remodeling Patterns in the Framingham Offspring Study

Introduction: The American Heart Association Heart Healthy score (AHA score or Life’s Simple 7™) is inversely associated with atherosclerotic vascular disease including heart failure (HF), but its relationship to adverse left ventricle (LV) geometric patterns (known precursors of HF) is unknown. LV geometry can be categorized into 4 distinct patterns: normal (normal LV mass [LVM] and relative wall thickness [RWT]), concentric remodeling (normal LVM with increased RWT), eccentric hypertrophy (increased LVM with normal RWT) and concentric hypertrophy (increased LVM and RWT). Hypothesis: We hypothesized that ideal cardiovascular health is inversely associated with adverse LV geometric patterns. Methods: We evaluated the cross-sectional relations between the AHA score (range 1-7, based on lifestyle and risk factor profile, 7 being healthiest) and the prevalence of echocardiographic LV geometric patterns in 2392 Framingham Offspring Study participants (mean age 58 years, 56% women). Using generalized logits models, we calculated odds ratios (OR) for each pattern of LV remodeling as compared to the normal pattern (that served as referent) for every unit-increase in AHA score, adjusting for age and sex. Results: Normal geometry was present in 1283 participants (54%), concentric remodeling in 486 (20%), eccentric hypertrophy in 352 (15%) and concentric hypertrophy in 271 (11%). Each unit- increase in the AHA score was associated with lower odds of concentric remodeling and hypertrophy, Table. We did not observe a significant association between the AHA score and the odds of eccentric hypertrophy. Conclusions: Our findings support the association between ideal cardiovascular health and a lower prevalence of adverse cardiac remodeling, consistent with the favorable impact of both a healthy lifestyle and optimal risk factor profile on HF risk.

The relationship between red-cell distribution width and abnormal left ventricle geometric patterns in patients with untreated essential hypertension

Abnormal left ventricle (LV) geometric patterns are associated with an increased risk of vascular complications of hypertension (HT). The association between red-cell distribution width (RDW) and HT has been recently investigated; however, the relationship between abnormal LV geometric patterns and RDW has not been studied before. The aim of this study was to investigate the relationship between RDW and abnormal LV geometric patterns in patients with untreated essential HT. Measurements were obtained from 139 patients with untreated essential HT (mean age=51.3±16.3 years). Four different geometric patterns (NG, normal geometry; CR, concentric remodeling; EH, eccentric hypertrophy; CH, concentric hypertrophy) were determined according to the LV mass index (LVMI) and relative wall thickness (RWT). RDW, lipid parameters and other biochemical markers were measured in all patients. While the highest RDW values were detected in the CH group (P<0.05, for all), it was similar among the NG, CR and EH groups (P>0.05, for all). RDW was associated with age, LVMI and LV geometry in bivariate analysis (P<0.05, for all). In a receiver operating characteristic (ROC) curve analysis, a level of RDW>14.5 predicted CH with 81% sensitivity and 59% specificity. Age (beta=0.309, P=0.001), LV geometry type (beta=0.228, P=0.01) and RWT (beta=-0.278; P=0.25) were independent predictors of high RDW in multiple linear regression analysis. In conclusion, the highest RDW values were observed in the CH group in the untreated essential HT patients. RDW seems to be a useful tool for the prediction of end-organ damage in patients with untreated essential HT.

Mean Platelet Volume and Abnormal Left Ventricle Geometric Patterns in Patients with Untreated Essential Hypertension

PP-024 Abnormal left ventricle (LV) geometric patterns are associated with a greater risk of hypertensive vascular complications. The mean platelet volume (MPV) reflects the platelet activity, and is associated with overall vascular mortality. Although association between MPV and LV hypertrophy in

Red Cell Distribution Width and Abnormal Left Ventricle Geometric Patterns in Patients with Untreated Essential Hypertension

Red Cell Distribution Width and Abnormal Left Ventricle Geometric Patterns in Patients with Untreated Essential Hypertension

High-sensitivity cardiac troponin T levels in newly diagnosed hypertensive patients with different left ventricle geometry

Background. The high-sensitivity cardiac troponin T (hs-cTnT) assay provides important prognostic information on cardiovascular diseases. Although hs-cTnT is associated with left ventricle (LV) hypertrophy (LVH), it has not been investigated in different LV geometric patterns incorporating normal LV structure and concentric remodeling in addition to LVH. Objectives. We aimed to investigate the possible association between hs-cTnT and LV geometric patterns in newly diagnosed hypertensive patients. Methods. We studied 306 patients with newly diagnosed hypertension (HT; mean age 51.7 ± 5.6 years) and 44 healthy control subjects (mean age 51.3 ± 4.7 years). Echocardiographic examination was performed in all subjects. Four different geometric patterns were determined in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWth). hs-cTnT and other biochemical markers were measured in all participants. Results. The highest hs-cTnT values were observed in the concentric hypertrophy group compared with the control, normal geometry, concentric remodeling and eccentric hypertrophy groups (p < 0.05, for all). Also, hs-cTnT values of the eccentric hypertrophy group were higher than the control, normal geometry and concentric remodeling groups (p < 0.05, for all). Multivariate regression analysis showed that hs-cTnT was independently associated with LV geometry (β = 0.326, p = 0.001) as well as LVMI (β = 0.228, p = 0.010) and creatinine level β = 0.132, p = 0.012). Conclusion. hs-cTnT level is related not only to LVH but also to LV geometry in hypertensive patients. hs-cTnT levels may mediate poorer LV geometric patterns in hypertensive patients.

N-terminal pro-brain natriuretic peptide levels and abnormal left ventricle geometric patterns in untreated hypertensive patients

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts cardiovascular events and mortality in hypertensive patients. Relationship between NT-proBNP level and left ventricle (LV) hypertrophy is well known in hypertensive patients. However, the studies investigating relation between abnormal LV geometric patterns and serum NT-proBNP level have conflicting results and are limited number. The goal of the present study is to investigate relation between NT-proBNP and abnormal LV geometric patterns in untreated hypertensive patients. Methods: Measurements were obtained from 273 patients with untreated essential hypertension (Mean age = 51.7±5.8 years) and 44 healthy control subjects (Mean age; 51.3±4.7). Four different geometric patterns (NG; normal geometry, CR; concentric remodelling, EH; eccentric hypertrophy, CH; concentric hypertrophy) were determined according to LV mass index (LVMI) and relative wall thickness. NT-proBNP and other biochemical markers were measured in all subjects. Results: The highest NT-proBNP levels were determined in CH group compared with control group and other geometric patterns (p 0.05) (Table 1). NT-proBNP was independently associated with left ventricle geometry (β=0.304, p=0.003) and LVMI (β=0.266, p=0.007) in multiple linear regression analysis. View this table: Table 1. Comparison of baseline, clinical and laboratory characteristics in the groups Conclusion: NT-proBNP levels are influenced not only by the extent of LV hypertrophy but also by the abnormal left ventricle geometry in untreated hypertensive patients with preserved ejection fraction.

Mean platelet volume and abnormal left ventricle geometric patterns in patients with untreated essential hypertension

Abnormal left ventricle (LV) geometric patterns are associated with a greater risk of hypertensive vascular complications. The mean platelet volume (MPV) reflects the platelet activity, and is associated with overall vascular mortality. Although association between MPV and LV hypertrophy in hypertensive patients has been investigated, relation between abnormal LV geometric patterns and MPV was not studied so far. The aim of this study is to investigate the relationship between MPV and abnormal LV geometric patterns in hypertensive patients. Measurements were obtained from 223 patients with untreated essential hypertension (Mean age = 52.1 ± 5.2 years). Four different geometric patterns (NG; normal geometry, CR; concentric remodelling, EH; eccentric hypertrophy, CH; concentric hypertrophy) were determined according to the LV mass index (LVMI) and relative wall thickness (RWth). MPV, high sensitive C-reactive protein (hsCRP) and other biochemical markers were measured in all patients. The highest MPV values were determined in CH group compared with NG, CR and EH groups (p < 0.05, for all). MPV values were similar among the NG, CR and EH groups (p > 0.05, for all). MPV was associated with age, glucose, hsCRP, RWth, LVMI and LV geometry in bivariate analysis (p < 0.05, for all). Age (β = 0.110, p = 0.033), LVMI (β = 0.471, p < 0.001) and hsCRP (β = 0.525, p < 0.001) were independent predictors of high MPV in multiple linear regression analysis. The highest MPV values were observed in the CH group. This result may be associated with increased inflammation and LV hypertrophy in this geometric pattern.

Relationship between left ventricle geometric patterns and lymphocyte DNA damage in patients with untreated essential hypertension

Objective: To investigate the association between different the left ventricle (LV) geometric patterns and lymphocyte DNA damage in patients with hypertension (HT). Methods: We studied 84 patients (50.0 ± 6.1, years) with HT and 24 healthy control subjects (48.6 ± 3.3, years). Four different geometric patterns were identified in patients according to LV mass index and relative wall thickness. Peripheral lymphocyte DNA damages and plasma levels of total antioxidant status (TAS) were determined in all subjects. Results: DNA damage was increased in hypertensive patients compared with control group ( p = 0.001). The major increase in DNA damage was observed in concentric hypertrophic geometric pattern compared with all other geometric patterns ( p < 0.001, for all). In multiple linear regression analysis, lymphocyte DNA damage was independently correlated with only TAS ( β = − 0.444, p < 0.001), but not LV geometry ( p > 0.05). Conclusion: The major increase in lymphocyte DNA damage was observed in concentric hypertrophic geometric pattern. This result may be related to increased oxidative stress.

Relationship between impaired elastic properties of aorta with left ventricle geometric patterns and left ventricle diastolic functions in patients with newly diagnosed essential hypertension

The aim of this study was to investigate the association between elastic properties of aorta with left ventricle (LV) geometric patterns and LV diastolic functions in patients with newly diagnosed hypertension (HT). We studied 149 patients with newly diagnosed HT and 29 healthy control subjects. Echocardiographic examination was performed to all subjects. Ascending aorta (Ao) diameters (mm/m2) and Ao elastic indexes - namely, Ao strain [AS] (%), Ao distensibility [AD] (cm2 dyn(-1) x 10(-6)) were calculated. Four different geometric patterns were identified in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWT). Tissue Doppler-derived Ea/Aa was determined from the all subjects. Patients vs. control subjects had lower mean AS and AD (p < 0.001 for both). Mean AS and AD of all geometric patterns significantly decreased compared with control group (p < 0.05 for all). Both AS and aortic AD of concentric remodelling (CR; p = 0.017 for both) and concentric hypertophic groups (p < 0.001 for both) were decreased compared with normal LV group. AS and AD of concentric hypertrophic pattern was lower than that of the CR group (p = 0.011 and 0.020 respectively) and the eccentric hypertrophic group (p < 0.001 and p = 0.002, respectively). Both AS and AD of the CR group were similar to that of the eccentric hypertrophic group (p > 0.05 for both). Both AS and AD were significantly correlated with age (beta = -0.178, p = 0.025, beta = -0.158, p = 0.029 respectively), LVMI (beta = -0.223, p = 0.022, beta = -263, p = 0.003 respectively), RWT (beta = -0.196, p = 0.019, beta = -0.189, p = 0.013 respectively) and Ea/Aa (beta = 0.174, p = 0.045, beta = 0.247, p = 0.002 respectively) in multiple linear regression analysis. Elastic properties of aorta were impaired in newly diagnosed HT. The degree of this impairment is different among various LV geometric patterns. In addition, impaired elastic properties of aorta were associated with RWT, LVMI and diastolic disfunctions, besides age, but not with LV geometry.

Relation between P-wave dispersion and left ventricular geometric patterns in newly diagnosed essential hypertension

Aim P-wave durations and P-wave dispersion (PD) are considered to reflect the heterogeneous conduction in atria. The aim of this study was to investigate PD and P-wave duration in different left ventricle geometric patterns of hypertensive patients. Methods One hundred forty-nine consecutive patients with newly diagnosed essential hypertension and 29 healthy control groups were included in the study. The maximum and minimum P-wave duration ( P max and P min, respectively) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed in all subjects. Four different geometric patterns were identified in hypertensive patients according to left ventricular mass index (LVMI) and relative wall thickness. Results P-wave dispersion was longer in concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) groups when compared with the control group ( P = .009, P < .001, P < .001, respectively). P-wave dispersion of normal left ventricle (NLV) geometric pattern was not different from that of the control group. Patients with NLV geometric pattern had shorter PD than patients who had CH and EH (NLV vs CH, P < .001; NLV vs EH, P = .025). P-wave dispersion of the NLV group was not different from that of the CR group. Patients with CR had also shorter PD than patients who had CH ( P = .002). In bivariate analysis, there was a significant correlation between PD with left ventricle geometry, body surface area, LVMI, and relative wall thickness. In multiple linear regression analysis, PD was independently correlated only with LVMI ( β = .425, P < .001). Conclusions P-wave dispersion is independently associated with LVMI rather than left ventricle geometry and relative wall thickness in hypertensive patients. Thus, it is increased particularly in patients with CH and EH.