Left ventricular diastolic dysfunction in newly diagnosed untreated hypertensive patients

Figures & data

Table I. Characteristics of control subjects and hypertensive patients (HT) without or with diastolic dysfunction (DD).

	Controls (n = 18)	HT with DD (n = 44)	HT without DD (n = 42)
Age (years)	44.2 ± 5.3	51.9 ± 7.1**	45.9 ± 10.7
Gender (M/F)	9/11	23/21	22/20
Body mass index (kg/m^2)	26.6 ± 3.3	29.1 ± 5.1	27.6 ± 3.9
Smokers (%)	55.5%	22.7%	34.1%
Systolic blood pressure (mmHg)	120.6 ± 6.4	174.2 ± 16.8**	171.6 ± 14.9**
Diastolic blood pressure (mmHg)	78.3 ± 5.1	99.3 ± 7.9**	98.2 ± 6.4**
Heart rate (beats/min)	73 ± 10.1	72.8 ± 9.8	70.3 ± 12.2
Plasma creatinine (mg/dl)	0.9 ± 0.08	0.93 ± 0.13	0.87 ± 0.18
Blood glucose (mg/dl)	90.3 ± 8.4	100.6 ± 9.9**	100.2 ± 10.1**
Total plasma cholesterol (mg/dl)	186.6 ± 18.1	208.7 ± 33.6*	202.1 ± 33.5**
LDL-cholesterol (mg/dl)	119.8 ± 19.5	134.1 ± 28.6	131.7 ± 26.1
HDL-cholesterol (mg/dl)	45.2 ± 8.5	46.5 ± 9.7	46.7 ± 9.3
Plasma triglycerides (mg/dl)	127.6 ± 27.5	139.3 ± 66.5	120.6 ± 63.1
Blood urea (mg/dl)	32.1 ± 5.3	30.0 ± 7.9	26.3 ± 7.6
Uric acid (mg/dl)	4.1 ± 1.4	4.8 ± 1	4.4 ± 1

Data are shown as means ± SEM. Asterisks (*p < 0.05, **p < 0.01) refer to the statistical significance between groups. M, males; F, females; LDL, low-density lipoprotein; HDL, high-density lipoprotein.

Table II. Echocardiographic data in normotensive controls and in hypertensive patients without or with diastolic dysfunction.

	Controls (n = 18)	Hypertensives without diastolic dysfunction (n = 42)	Hypertensives with diastolic dysfunction (n = 44)
End-diastolic diameter (cm)	4.70 ± 0.40	4.85 ± 0.31	4.83 ± 0.41
End-systolic diameter (cm)	2.82 ± 0.25	2.86 ± 0.31	2.88 ± 0.33
Left atrial diameter (cm)	3.42 ± 0.26	3.71 ± 0.26**	3.73 ± 0.31**
Ejection fraction (%)	70.7 ± 3.8	71.8 ± 4.6	70.9 ± 4.3
Left ventricular mass index (g/m^2)	97.1 ± 18.2	99.6 ± 9.8	100.4 ± 13.5
Posterior wall thickness (mm)	8.0 ± 1.9	9.9 ± 1.6**	9.6 ± 2.1**
Intraventricular septal thickness (mm)	9.0 ± 1.7	9.9 ± 1.5*	11.2 ± 1.4**##
Relative wall thickness (%)	0.34 ± 0.95	0.4 ± 1.03	0.39 ± 1

Data are shown as means ± SEM. *p < 0.05 vs controls, *p < 0.01 vs controls, ^#p < 0.05 vs hypertensives without diastolic dysfunction, ^##p < 0.01 vs hypertensives without diastolic dysfunction.

Figure 1. Behaviour of deceleration time of E velocity (DT), isovolumic relaxation time (IVRT), endocardial fractional shortening (EFS), systodiastolic ratio (S/D), peak pulmonary vein systolic (PVs), diastolic (PVd) and average (PVa) velocity values and filling time in normotensive subjects (C, open bars) and in age-matched essential untreated and newly diagnosed hypertensive patients without (HT, grey bars) and with (HTD, black bars) left ventricular diastolic dysfunction. Data are shown as means ± SEM. Asterisks (*p < 0.05, **p < 0.01) refer to the statistical significance between groups.

Figure 2. Behaviour of deceleration time of Em/Am ratio, myocardial systolic peak velocity (Sm), E/Em ratio, deceleration time of E velocity (DT), isovolumic relaxation time (IVRT) in normoresive subjects (C, open bars) and in age-matched essential untreated and newly diagnosed hypertensive patients without (HT, grey bars) and with (HTD, black bars) left ventricular diastolic dysfunction. Data are related to the lateral and septal mitral annulus or averaged together Data are shown as means ± SEM. Asterisks (*p < 0.05, **p < 0.01) refer to the statistical significance between groups.

Table III. Person's correlation between E/A and E’/A’ with clinical variables.

	Mitral E/A ratio			E’/A’
	R	p-value	R	p-value
Age	−0.351	0.0197	−0.299	0.0484
Body mass index	0.193	0.2103	0.395	0.0080
Left ventricular mass	−0.375	0.0121	−0.300	0.0480
Left ventricular mass index	−0.465	0.0015	−0.329	0.0292
Heart rate	−0.158	0.3049	−0.188	0.2225
Systolic blood pressure	−0.200	0.1920	−0.192	0.2107
Diastolic blood pressure	− 0.003	0.9860	−0.092	0.5517
Fasting blood glucose	−0.108	0.4873	−0.004	0.9796
Plasma creatinine	−0.293	0.0533	−0.347	0.0208
Total plasma cholesterol	0.161	0.2972	0.017	0.9150
LDL-cholesterol	0.116	0.4533	−0.021	0.8948
HDL-cholesterol	0.061	0.6923	−0.055	0.7252
Plasma triglycerides	0.189	0.2198	0.158	0.3058
Uric acid	−0.050	0.7477	0.072	0.6418
Blood urea	−0.264	0.0836	−0.221	0.1494

LDL, low-density lipoprotein; HDL, high-density lipoprotein.

Table IV. Linear regression models – stepwise selection.

Dependent variables	Independent variables	Beta	SE	p-value
E/A	LVMI	−0.0016	0.0005	0.0044
		R^2 = 0.2819
E’/A’	BMI	0.0153	0.0051	0.0044
	LVMI	−0.0021	0.0009	0.0202
		R^2 = 0.3178

LVMI, left ventricular mass index; BMI, body mass index.