Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study

Casper Bang; Eva Gerdts; Gerard P Aurigemma; Kurt Boman; Björn Dahlöf; Mary J Roman; Lars Køber; Kristian Wachtell; Richard B Devereux

doi:10.1097/HJH.0b013e328362bbd6

Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study

Casper Bang, Eva Gerdts, Gerard P Aurigemma, Kurt Boman, Björn Dahlöf, Mary J Roman, Lars Køber, Kristian Wachtell, Richard B Devereux

Institut for Klinisk Medicin

14 Citationer (Scopus)

Abstract

Background: Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV(2/3))] in hypertensive patients. Methods and results: Nine hundred thirty-nine participants in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy had measurable LVM at enrolment. Patients with LVH (LVM/body surface area ≥116 g/m2 in men and ≥96 g/m2 in women) were divided into four groups; 'eccentric nondilated' (normal LVM/EDV and EDV), 'eccentric dilated' (increased EDV, normal LVM/EDV), 'concentric nondilated' (increased LVM/EDV with normal EDV), and 'concentric dilated' (increased LVM/EDV and EDV) and compared to patients with normal LVM. At baseline, 12% had eccentric nondilated, 20% eccentric dilated, 29% concentric nondilated, and 14% concentric dilated LVH, with normal LVM in 25%. Compared with the concentric nondilated LVH group, those with concentric dilated LVH had significantly lower pulse pressure/stroke index and ejection fraction; higher LVM index, stroke volume, cardiac output, left ventricular midwall shortening, left atrial volume and isovolumic relaxation time; and more had segmental wall motion abnormalities (all P<0.05). Similar differences existed between patients with eccentric dilated and those with eccentric nondilated LVH (all P<0.05). Compared with patients with normal LVM, the eccentric nondilated had higher LV stroke volume, pulse pressure/stroke index, Cornell voltage product and SBP, and lower heart rate and fewer were African-American (all P<0.05). Conclusion: The new four-group classification of LVH identifies dilated subgroups with reduced left ventricular function among patients currently classified with eccentric or concentric LVH.

Originalsprog	Engelsk
Tidsskrift	Journal of Hypertension
Vol/bind	31
Udgave nummer	10
Sider (fra-til)	2060-2068
Antal sider	9
ISSN	0263-6352
DOI	https://doi.org/10.1097/HJH.0b013e328362bbd6
Status	Udgivet - okt. 2013

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10.1097/HJH.0b013e328362bbd6

Citationsformater

Bang, C., Gerdts, E., Aurigemma, G. P., Boman, K., Dahlöf, B., Roman, M. J., Køber, L., Wachtell, K., & Devereux, R. B. (2013). Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study. Journal of Hypertension, 31(10), 2060-2068. https://doi.org/10.1097/HJH.0b013e328362bbd6

Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients : the Losartan Intervention For Endpoint reduction in hypertension study. / Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P et al.

I: Journal of Hypertension, Bind 31, Nr. 10, 10.2013, s. 2060-2068.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Bang, C, Gerdts, E, Aurigemma, GP, Boman, K, Dahlöf, B, Roman, MJ, Køber, L, Wachtell, K & Devereux, RB 2013, 'Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study', Journal of Hypertension, bind 31, nr. 10, s. 2060-2068. https://doi.org/10.1097/HJH.0b013e328362bbd6

@article{a451186a352b4dbf90cea9fac8ed763f,

title = "Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study",

abstract = "Background: Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV(2/3))] in hypertensive patients. Methods and results: Nine hundred thirty-nine participants in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy had measurable LVM at enrolment. Patients with LVH (LVM/body surface area ≥116 g/m2 in men and ≥96 g/m2 in women) were divided into four groups; 'eccentric nondilated' (normal LVM/EDV and EDV), 'eccentric dilated' (increased EDV, normal LVM/EDV), 'concentric nondilated' (increased LVM/EDV with normal EDV), and 'concentric dilated' (increased LVM/EDV and EDV) and compared to patients with normal LVM. At baseline, 12% had eccentric nondilated, 20% eccentric dilated, 29% concentric nondilated, and 14% concentric dilated LVH, with normal LVM in 25%. Compared with the concentric nondilated LVH group, those with concentric dilated LVH had significantly lower pulse pressure/stroke index and ejection fraction; higher LVM index, stroke volume, cardiac output, left ventricular midwall shortening, left atrial volume and isovolumic relaxation time; and more had segmental wall motion abnormalities (all P<0.05). Similar differences existed between patients with eccentric dilated and those with eccentric nondilated LVH (all P<0.05). Compared with patients with normal LVM, the eccentric nondilated had higher LV stroke volume, pulse pressure/stroke index, Cornell voltage product and SBP, and lower heart rate and fewer were African-American (all P<0.05). Conclusion: The new four-group classification of LVH identifies dilated subgroups with reduced left ventricular function among patients currently classified with eccentric or concentric LVH.",

author = "Casper Bang and Eva Gerdts and Aurigemma, {Gerard P} and Kurt Boman and Bj{\"o}rn Dahl{\"o}f and Roman, {Mary J} and Lars K{\o}ber and Kristian Wachtell and Devereux, {Richard B}",

year = "2013",

month = oct,

doi = "10.1097/HJH.0b013e328362bbd6",

language = "English",

volume = "31",

pages = "2060--2068",

journal = "Journal of Hypertension",

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}

TY - JOUR

T1 - Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

T2 - the Losartan Intervention For Endpoint reduction in hypertension study

AU - Bang, Casper

AU - Gerdts, Eva

AU - Aurigemma, Gerard P

AU - Boman, Kurt

AU - Dahlöf, Björn

AU - Roman, Mary J

AU - Køber, Lars

AU - Wachtell, Kristian

AU - Devereux, Richard B

PY - 2013/10

Y1 - 2013/10

N2 - Background: Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV(2/3))] in hypertensive patients. Methods and results: Nine hundred thirty-nine participants in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy had measurable LVM at enrolment. Patients with LVH (LVM/body surface area ≥116 g/m2 in men and ≥96 g/m2 in women) were divided into four groups; 'eccentric nondilated' (normal LVM/EDV and EDV), 'eccentric dilated' (increased EDV, normal LVM/EDV), 'concentric nondilated' (increased LVM/EDV with normal EDV), and 'concentric dilated' (increased LVM/EDV and EDV) and compared to patients with normal LVM. At baseline, 12% had eccentric nondilated, 20% eccentric dilated, 29% concentric nondilated, and 14% concentric dilated LVH, with normal LVM in 25%. Compared with the concentric nondilated LVH group, those with concentric dilated LVH had significantly lower pulse pressure/stroke index and ejection fraction; higher LVM index, stroke volume, cardiac output, left ventricular midwall shortening, left atrial volume and isovolumic relaxation time; and more had segmental wall motion abnormalities (all P<0.05). Similar differences existed between patients with eccentric dilated and those with eccentric nondilated LVH (all P<0.05). Compared with patients with normal LVM, the eccentric nondilated had higher LV stroke volume, pulse pressure/stroke index, Cornell voltage product and SBP, and lower heart rate and fewer were African-American (all P<0.05). Conclusion: The new four-group classification of LVH identifies dilated subgroups with reduced left ventricular function among patients currently classified with eccentric or concentric LVH.

AB - Background: Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV(2/3))] in hypertensive patients. Methods and results: Nine hundred thirty-nine participants in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy had measurable LVM at enrolment. Patients with LVH (LVM/body surface area ≥116 g/m2 in men and ≥96 g/m2 in women) were divided into four groups; 'eccentric nondilated' (normal LVM/EDV and EDV), 'eccentric dilated' (increased EDV, normal LVM/EDV), 'concentric nondilated' (increased LVM/EDV with normal EDV), and 'concentric dilated' (increased LVM/EDV and EDV) and compared to patients with normal LVM. At baseline, 12% had eccentric nondilated, 20% eccentric dilated, 29% concentric nondilated, and 14% concentric dilated LVH, with normal LVM in 25%. Compared with the concentric nondilated LVH group, those with concentric dilated LVH had significantly lower pulse pressure/stroke index and ejection fraction; higher LVM index, stroke volume, cardiac output, left ventricular midwall shortening, left atrial volume and isovolumic relaxation time; and more had segmental wall motion abnormalities (all P<0.05). Similar differences existed between patients with eccentric dilated and those with eccentric nondilated LVH (all P<0.05). Compared with patients with normal LVM, the eccentric nondilated had higher LV stroke volume, pulse pressure/stroke index, Cornell voltage product and SBP, and lower heart rate and fewer were African-American (all P<0.05). Conclusion: The new four-group classification of LVH identifies dilated subgroups with reduced left ventricular function among patients currently classified with eccentric or concentric LVH.

U2 - 10.1097/HJH.0b013e328362bbd6

DO - 10.1097/HJH.0b013e328362bbd6

M3 - Journal article

C2 - 23838656

SN - 0263-6352

VL - 31

SP - 2060

EP - 2068

JO - Journal of Hypertension

JF - Journal of Hypertension

IS - 10

ER -

Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients: the Losartan Intervention For Endpoint reduction in hypertension study

Abstract

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