Left ventricular geometry and diastolic function in the hypertensive heart: Impact of age

Figures & data

Table I. Clinical and echocardiographic characteristics in younger hypertensive patients categorized by left ventricular geometry.

Left ventricular geometry	I: Normal (n = 102)	II: Concentric remodeling (n = 48)	III: Eccentric LVH (n = 70)	IV: Concentric LVH (n = 78)	p-value
Age (years)	50.8 ± 8.4	55.5 ± 6.6	54.6 ± 9.0	55.0 ± 8.0^a	< 0.01
Gender (% men)	41.6	50.0	57.1	66.7	NS
BMI (kg/m^2)	25.8 ± 3.8	26.5 ± 3.6	29.8 ± 5.7	30.1 ± 4.7^b	< 0.001
Clinic SBP (mmHg)	133.1 ± 15.1	134.1 ± 18.8	140.2 ± 17.1	140,7 ± 16,0^b	< 0.001
Clinic DBP (mmHg)	83.7 ± 10.7	83.5 ± 10.0	86.2 ± 11.1	86.5 ± 10.5^b	< 0.01
Heart rate (beats/min)	73.6 ± 9.8	72.1 ± 9.0	71.4 ± 10.5	73.1 ± 9.4	NS
Obesity (%)	14.7	20.8	44.3	46.2^b	< 0.001
Current smoking (%)	22.2	18.2	18.8	15.8	NS
Type 2 diabetes (%)	4.9	12.5	4.3	11.5	NS
Anti-hypertensive drugs (%)	78.4	87.5	88.6	87.2	NS
RWT	0.38 ± 0.04	0.46 ± 0.03	0.39 ± 0.03	0.47 ± 0.04^c	< 0.001
LVM (g)	162.6 ± 33.6	169.7 ± 34.2	233.6 ± 43.0	241.3 ± 43.0^b	< 0.001
LVMI (g/m^2.7)	41.2 ± 6.3	42.7 ± 6.2	61.5 ± 9.6	62.5 ± 9.1^b	< 0.001
E/A ratio	1.10 ± 0.30	1.04 ± 0.30	1.01 ± 0.34	1.00 ± 0.40^a	< 0.01
DT (ms)	206.8 ± 47.6	228.6 ± 44.9	220.8 ± 53.4	237.9 ± 65.3^c	< 0.01
Ei velocity lat (cm/s)	10.3 ± 3.5	10.9 ± 3.3	9.7 ± 3.9	8.5 ± 2.8^d	< 0.01
Ei/Ai ratio	1.00 ± 0.40	1.03 ± 0.40	0.91 ± 0.40	0.87 ± 0.44^b	< 0.01
E/Ei ratio	8.2 ± 2.4	7.4 ± 2.1	9.1 ± 3.4	9.4 ± 2.6	< 0.001

Data are shown as means ± SD or percent, p-values are based on either analysis of variance (for continuous measures) or chi-square test (for categorical variables). ^aIV vs I; ^bIV vs II, I; ^cIV vs III, I; ^dIV vs III, II, I. BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; RWT, relative wall thickness; LVM, left ventricular mass; LVMI, left ventricular mass index; E/A ratio, early to late mitral flow velocity ratio; DT, mitral deceleration time; Ei, early annular velocity; Ei/Ai ratio, early to late annular velocity ratio.

Table II. Demographic and clinical characteristics in elderly hypertensive categorized by left ventricular geometry.

Left ventricular geometry	I: Normal (n = 49)	II: Concentric remodeling (n = 55)	III: Eccentric LVH (n = 94)	IV: Concentric LVH (n = 164)	p-value
Age (years)	72.4 ± 5.2	74.0 ± 6.0	74.0 ± 4.8	74.2 ± 5.6^a	< 0.05
Gender (% men)	40.8	43.6	43.6	47.5	NS
BMI (kg/m^2)	25.6 ± 2.7	26.1 ± 4.4	29.2 ± 4.9	30.0 ± 4.5^b	< 0.001
Clinic SBP (mmHg)	142 ± 15	140 ± 17	142 ± 19	147 ± 19^c	< 0.01
Clinic DBP (mmHg)	80 ± 8	79 ± 8	79 ± 9	81 ± 9	NS
Heart rate (beats/min)	70 ± 10	73 ± 9	70 ± 10	72 ± 11	NS
Obesity (%)	6.1	21.8	45.7	51.8^b	< 0.001
Current smoking (%)	6.2	12.7	7.9	9.5	NS
Type 2 diabetes (%)	6.1	18.2	13.8	11.0	NS
Anti-hypertensive drugs (%)	93.9	94.5	97.9	95.1	NS
RWT	0.39 ± 0.03	0.47 ± 0.03	0.39 ± 0.03	0.47 ± 0.04^d	< 0.001
LVM (g)	163.3 ± 38.8	158.0 ± 30.3	236.1 ± 51.4	236.1 ± 53.0^b	< 0.001
LVMI (g/m^2.7)	43.5 ± 5.8	43.5 ± 5.6	65.6 ± 12.0	67.4 ± 12.8^b	< 0.001
E/A ratio	0.86 ± 0.30	0.78 ± 0.19	0.84 ± 0.30	0.77 ± 0.30^d	< 0.05
DT (ms)	234.0 ± 66.0	247.6 ± 55.3	254.6 ± 76.8	248.7 ± 59.3	NS
Ei velocity lat (cm/s)	8.60 ± 2.1	7.93 ± 5.49	7.19 ± 2.64	6.87 ± 2.42^b	< 0.001
Ei/Ai ratio	0.74 ± 0.25	0.68 ± 0.24	0.74 ± 0.36	0.68 ± 0.33	NS
E/Ei ratio	9.6 ± 2.9	10.1 ± 3.4	10.8 ± 3.8	11.6 ± 4.2^b	< 0.05

Data are shown as means ± SD or percent, p-values are based on either analysis of variance (for continuous measures) or chi-square test (for categorical variables). ^aIV vs I; ^bIV vs II, I; ^cIV vs III, II, I; ^dIV vs III, I. For abbreviations, see Table I.

Figure 1. Prevalence rates of left ventricular hypertrophy (LVH), left atrial enlargement (LAE) and abnormal left ventricular filling index (ALVFI) in younger and in older subjects. *p < 0.01.

Table III. Univariate correlation analysis between left ventricular mass and clinical/echocardiographic parameters in the study population as a whole and in the two age groups.

	Total population		< 65 years		≥ 65 years
Variable	r	p	r	p	r	p
Age	0.10	0.02	0.23	< 0.001	0.03	NS
Weight	0.54	< 0.001	0.59	< 0.001	0.54	< 0.001
Height	0.37	< 0.001	0.44	< 0.001	0.41	< 0.001
BSA	0.54	< 0.001	0.59	< 0.001	0.56	< 0.001
BMI	0.37	< 0.001	0.38	< 0.001	0.35	< 0.001
Clinic SBP	0.21	< 0.001	0.29	< 0.01	0.14	< 0.01
Clinic DBP	0.14	< 0.001	0.27	< 0.01	0.08	NS
EF	− 0.21	< 0.001	− 0.15	< 0.01	− 0.22	NS
LAVI	0.31	< 0.001	0.32	< 0.001	0.28	< 0.001
E	− 0.03	NS	− 0.11	NS	− 0.03	NS
A	0.04	NS	0.04	NS	0.04	NS
E/A ratio	− 0.02	NS	− 0.05	NS	− 0.10	NS
DT	0.11	< 0.01	0.20	< 0.001	0.02	NS
Ei	− 0.17	< 0.001	− 0.22	< 0.001	− 0.07	NS
Ai	0.02	NS	0.06	< 0.001	0.08	NS
Ei/Ai ratio	0.10	0.02	0.18	< 0.01	0.05	NS
E/Ei	− 0.13	< 0.01	− 0.16	< 0.01	− 0.08	NS

BSA, body surface area; EF, ejection fraction; LAVI, left atrial volume indexed to BSA (for other abbreviations, see Table I).

Table IV. Univariate correlation analysis between relative wall thickness and clinical/echocardiographic parameters in the study population as a whole and in the two age groups.

	Total population		< 65 years		≥ 65 years
Variable	r	p	r	p	r	p
Age	0.23	< 0.001	0.18	< 0.01	0.11	< 0.05
Weight	0.04	NS	0.12	< 0,05	0.01	NS
Height	0.07	NS	0.03	NS	0.07	NS
BSA	0.01	NS	0.10	NS	0.03	NS
BMI	0.10	< 0.01	0.13	< 0.05	0.06	NS
Clinic SBP	0.13	< 0.01	0.07	NS	0.11	0.05
Clinic DBP	0.02	NS	0.04	NS	0.10	NS
EF	− 0.07	NS	− 0.12	< 0.05	− 0.14	< 0.01
LAVI	0.04	NS	0.04	NS	0.02	NS
E	− 0.06	NS	− 0.16	< 0.01	− 0.03	NS
A	0.19	< 0.001	0.05	NS	0.19	< 0.001
E/A ratio	− 0.19	< 0.001	0.15	< 0.01	0.12	< 0.05
DT	0.15	< 0.001	0.22	< 0.001	0.04	NS
Ei	− 0.21	< 0.001	− 0.20	< 0.001	− 0.12	< 0.05
Ai	0.04	NS	0.02	NS	0.03	NS
Ei/Ai ratio	0.16	< 0.001	0.12	< 0.05	0.10	NS
E/Ei	0.17	< 0.001	0.06	NS	0.16	< 0.01

For abbreviations, see Tables I and III.