Aortic wall elasticity and left ventricular function in hypertensive patients with nonsignificant coronary artery disease

Ultrasound ◽  
2020 ◽  
pp. 1742271X2096334
Author(s):  
Maryam Nabati ◽  
Shojaoddin Namazi ◽  
Jamshid Yazdani

Purpose Hypertension is an important cause of nonischemic heart failure. It is important to identify subclinical left ventricular dysfunction in patients with hypertension in an early stage to lower the risk of progression to more severe illness. The aim of our study was to assess the correlation between indices of left ventricular function and aortic stiffness in patients with hypertension. Methods Our study was a case control study of 42 hypertensive and 40 normotensive patients with nonsignificant coronary artery disease. All the patients underwent echocardiography and left ventricular ejection fraction, global longitudinal strain, post systolic index, pulsed Doppler early transmitral peak flow velocity, early diastolic mitral annular velocity (e′), and aortic elasticity measurements were calculated. Results The hypertensive patients were older (58.47 ± 9.57 vs. 52.94 ± 10.38 years, p = 0.018) and had a higher body mass index (30.09 ± 5.08 vs. 27.48 ± 4.17 kg/m2, p = 0.013) and E/e′ ratio (8.16 ± 1.81 vs. 6.56 ± 1.71, p < 0.001) and a lower e′ velocity (8.25 ± 2.28 vs. 9.52 ± 2.34 cm/s, p = 0.015) than normotensives. They also had a lower aortic distensibility ( p = 0.008) and a higher aortic stiffness index ( p = 0.039) compared with the normotensive group. The hypertensive patients did not show any association between aortic elasticity and stiffness with age or e′ velocity despite significant association in normotensives. Conclusion Hypertension is associated with a high prevalence of diastolic dysfunction, elevated left ventricular filling pressure, and increased arterial stiffness, all of which have significant association with adverse outcomes. The measurements found in the hypertensive patients compared with the normotensive group may be due to several age-independent mechanisms.

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Molenaar ◽  
B J Bouma ◽  
I Isgum ◽  
N J Verouden ◽  
J L Selder ◽  
...  

Abstract Introduction Left ventricular function (LVF) is a well-known recognized predictor of major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD) and is recommended in all CAD patients by the guidelines of the European Society of Cardiology. As non-obstructive CAD is more common among women, the predictive value of LVF might differ between men and women. Purpose The aim of this study is to evaluate sex-related differences in the predictive value of LVF in patients with suspected or documented CAD. Methods Patients with suspected or documented CAD who underwent transthoracic echocardiography (TTE) with LVF assessment in a tertiary center between 2014 and 2021 were included. LVF was classified with left ventricular ejection fraction (LVEF) as normal (≥52%) or impaired (LVEF &lt;52%). MACE were defined as death, heart failure (HF), acute coronary syndrome (ACS) and stroke. Time-to-first-event analysis was performed with Kaplan-Meier survival analysis and multivariate Cox proportional hazard analysis adjusting for age as covariate. Results In total, 1763 patients were included of which 59% were men (age 65±12 years) and 41% were women (age 65±13 years). 225 (22%) men and 100 (14%) women had impaired LVF (p&lt;0.001). Median follow-up time was 1.9 years (1.2–3.8); median event-free survival for men and women was 1.6 years (1.0–3.3) and 1.6 years (1.0–3.0), respectively (p=0.8). MACE and deaths were reported in 422 patients (23% of men, 25% of women) and 15 patients (12% of men, 10% of women), respectively. Impaired LVF was associated with a significantly higher risk of MACE in both men (HR 1.3, 95% CI: 1.2–1.4, p&lt;0.005) and women (HR 1.2, 95% CI: 1.0–1.3, p=0.02). Conclusions Impaired LVF was more common in men with suspected or documented CAD. In patients with impaired LVF, the predictive value of LVF is similar for both men and women. FUNDunding Acknowledgement Type of funding sources: Private hospital(s). Main funding source(s): Amsterdam UMC, Amsterdam MACE_men_women


2009 ◽  
Vol 73 (9) ◽  
pp. 1740-1745 ◽  
Author(s):  
Hidekatsu Fukuta ◽  
Nobuyuki Ohte ◽  
Seiji Mukai ◽  
Kaoru Asada ◽  
Kazuaki Wakami ◽  
...  

1984 ◽  
Vol 48 (6) ◽  
pp. 552-558 ◽  
Author(s):  
KIYOTAKA KAKU ◽  
YUZO HIROTA ◽  
GEN SHIMIZU ◽  
KOICHI FURUBAYASHI ◽  
KEISHIRO KAWAMURA

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