Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | American Journal of Cardiology |
| Vol/bind | 104 |
| Udgave nummer | 8 |
| Sider (fra-til) | 1098-104 |
| Antal sider | 6 |
| ISSN | 0002-9149 |
| DOI | |
| Status | Udgivet - 2009 |
Bibliografisk note
Keywords: Aged; Antihypertensive Agents; Blood Flow Velocity; Echocardiography, Doppler; Female; Follow-Up Studies; Humans; Hypertension; Hypertrophy, Left Ventricular; Losartan; Male; Mitral Valve; Treatment Outcome; Ventricular Function, LeftAdgang til dokumentet
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I: American Journal of Cardiology, Bind 104, Nr. 8, 2009, s. 1098-104.
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Mitral E wave deceleration time to peak E velocity ratio and cardiovascular outcome in hypertensive patients during antihypertensive treatment (from the LIFE echo-substudy)
AU - Chinali, Marcello
AU - Aurigemma, Gerard P
AU - de Simone, Giovanni
AU - Mishra, Rakesh K
AU - Gerdts, Eva
AU - Wachtell, Kristian
AU - Boman, Kurt
AU - Dahlöf, Björn
AU - Devereux, Richard B
N1 - Keywords: Aged; Antihypertensive Agents; Blood Flow Velocity; Echocardiography, Doppler; Female; Follow-Up Studies; Humans; Hypertension; Hypertrophy, Left Ventricular; Losartan; Male; Mitral Valve; Treatment Outcome; Ventricular Function, Left
PY - 2009
Y1 - 2009
N2 - The early mitral flow deceleration time (DTE) is a prognostically validated marker of left ventricular diastolic dysfunction. It has been reported that the DTE is influenced by the loading conditions, which can vary during antihypertensive treatment. We hypothesized that normalization of the DTE for mitral peak E-velocity (mitral deceleration index [MDI]) might better predict incident cardiovascular (CV) events in hypertensive patients during treatment compared to DTE alone or other traditional indexes of diastolic function, such as the mitral E/A ratio. We evaluated 770 hypertensive patients with electrocardiogram findings of left ventricular hypertrophy (age 66 +/- 7 years; 42% women) enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic substudy. Echocardiographic examinations were performed annually for 5 years during intensive antihypertensive treatment. We examined the utility of the MDI at baseline and as a time-varying predictor of incident CV events. Of the 770 patients, 70 (9%) had CV events. The baseline MDI was positively associated with age and relative wall thickness and negatively associated with gender and heart rate (all p <0.01). Unadjusted Cox regression analysis showed a positive association between the baseline MDI and CV events (hazard ratio 1.21, 95% confidence interval 1.07 to 1.37, p = 0.002). In the time-varied Cox models, a greater in-treatment MDI was associated with a greater rate of CV events (hazard ratio 1.43, 95% confidence interval 1.05 to 1.93, p = 0.022), independently of the covariates. No significant association was found for in-treatment DTE or any of the prognostically validated indexes of diastolic function. In conclusion, in our population of patients with treated hypertension with electrocardiographic findings of left ventricular hypertrophy, the MDI independently predicted future CV events. Normalization of DTE for E velocity might be preferred to other traditional diastolic function indexes in evaluating diastolic function during antihypertensive treatment.
AB - The early mitral flow deceleration time (DTE) is a prognostically validated marker of left ventricular diastolic dysfunction. It has been reported that the DTE is influenced by the loading conditions, which can vary during antihypertensive treatment. We hypothesized that normalization of the DTE for mitral peak E-velocity (mitral deceleration index [MDI]) might better predict incident cardiovascular (CV) events in hypertensive patients during treatment compared to DTE alone or other traditional indexes of diastolic function, such as the mitral E/A ratio. We evaluated 770 hypertensive patients with electrocardiogram findings of left ventricular hypertrophy (age 66 +/- 7 years; 42% women) enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic substudy. Echocardiographic examinations were performed annually for 5 years during intensive antihypertensive treatment. We examined the utility of the MDI at baseline and as a time-varying predictor of incident CV events. Of the 770 patients, 70 (9%) had CV events. The baseline MDI was positively associated with age and relative wall thickness and negatively associated with gender and heart rate (all p <0.01). Unadjusted Cox regression analysis showed a positive association between the baseline MDI and CV events (hazard ratio 1.21, 95% confidence interval 1.07 to 1.37, p = 0.002). In the time-varied Cox models, a greater in-treatment MDI was associated with a greater rate of CV events (hazard ratio 1.43, 95% confidence interval 1.05 to 1.93, p = 0.022), independently of the covariates. No significant association was found for in-treatment DTE or any of the prognostically validated indexes of diastolic function. In conclusion, in our population of patients with treated hypertension with electrocardiographic findings of left ventricular hypertrophy, the MDI independently predicted future CV events. Normalization of DTE for E velocity might be preferred to other traditional diastolic function indexes in evaluating diastolic function during antihypertensive treatment.
U2 - 10.1016/j.amjcard.2009.05.063
DO - 10.1016/j.amjcard.2009.05.063
M3 - Journal article
C2 - 19801032
SN - 0002-9149
VL - 104
SP - 1098
EP - 1104
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -