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Left ventricular mass and systolic dysfunction in essential hypertension

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Abstract

A relation between left ventricular (LV) hypertrophy and depressed midwall systolic function has been described in hypertensive subjects. However, a strong confounding factor in this relation is concentric geometry, which is both a powerful determinant of depressed midwall systolic function and a correlate of LV mass in hypertension. To evaluate the independent contribution of LV mass to depressed systolic function, 1827 patients with never-treated essential hypertension (age 48 ± 12 years, men 58%) underwent M-mode echocardiography under two-dimensional guidance. Relative wall thickness was the strongest determinant of low midwall fractional shortening (r = −0.63, P < 0.0001). The significant inverse relation observed between LV mass and midwall fractional shortening (r = −0.43, P < 0.0001) persisted after taking into account the effect of relative wall thickness (partial r = −0.27, P < 0.0001). Within each sex-specific quintile of relative wall thickness, prevalence of subnormal afterload-corrected midwall systolic function was greater in subjects with, than in subjects without, LV hypertrophy (P < 0.05 for the first, third, fourth and fifth quintile). In a multiple linear regression analysis, both LV mass (P < 0.0001) and relative wall thickness (P < 0.0001) were independent predictors of a reduced midwall fractional shortening. In conclusion, the inverse association between LV mass and midwall systolic function is partly independent from the effect of relative wall thickness. LV hypertrophy is a determinant of subclinical LV dysfunction independently of the concomitant changes in chamber geometry.

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Authors and Affiliations

  1. Unit of Internal Medicine, Angiology and Arteriosclerosis, University of Perugia, Italy

    G Schillaci, G Vaudo & L Pasqualini

  2. Department of Internal Medicine, University of Perugia, Italy

    G Reboldi

  3. Department of Cardiology, ‘R. Silvestrini’ Hospital, Perugia, Italy

    C Porcellati & P Verdecchia

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  1. G Schillaci
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  2. G Vaudo
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  3. L Pasqualini
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  4. G Reboldi
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  5. C Porcellati
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  6. P Verdecchia
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Correspondence to G Schillaci.

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Schillaci, G., Vaudo, G., Pasqualini, L. et al. Left ventricular mass and systolic dysfunction in essential hypertension. J Hum Hypertens 16, 117–122 (2002). https://doi.org/10.1038/sj.jhh.1001302

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  • DOI: https://doi.org/10.1038/sj.jhh.1001302

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