Longitudinal Mitral Annulus Velocities Are Reduced in Hypertensive Subjects With or Without Left Ventricle Hypertrophy

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 47; no. 5; pp. 854 - 860
• Main Authors: Borges, Maria Cândida C, Colombo, Roberta C.R, Gonçalves, José Geraldo F, Ferreira, José de Oliveira, Franchini, Kleber G
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.05.2006; Hagerstown, MD Lippincott
• Subjects: Adult; Aged; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity; Cardiology. Vascular system; Case-Control Studies; Diastole; Echocardiography; Experimental diseases; Female; Heart; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Hypertension - complications; Hypertension - physiopathology; Hypertrophy, Left Ventricular - complications; Hypertrophy, Left Ventricular - diagnostic imaging; Male; Medical sciences; Middle Aged; Mitral Valve - physiopathology; Single-Blind Method; Systole; Human; Hypertension; Systolic pressure; Echocardiography; Tissue doppler; Cardiovascular disease; myocardium; Left ventricle; Body mass index; Arterial pressure; Blood pressure; cardiac function; Ejection fraction
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.HYP.0000216123.57284.b0

Normotensive and hypertensive subjects with and without left ventricular (LV) hypertrophy (LV mass index [LVMI] >51 g/m) were examined by conventional echocardiography and tissue Doppler imaging of mitral annulus motion. The subgroups included nonobese normotensive subjects (n=16; age 51±9 years; 11 female; systolic blood pressure [SBP] 109±11 mm Hg, body mass index [BMI] 24±2.7 kg/m; LVMI 32±5.5 g/m), nonobese hypertensive subjects without LV hypertrophy (n=16; age 54±12 years; 12 female; SBP 166±15 mm Hg; BMI 25±2.7 kg/m; LVMI 42±5.5 g/m), and hypertensive subjects with LV hypertrophy (n=22; age 56±10 years; 10 female; SBP 181±19 mm Hg; BMI 26±2.3 kg/m; LVMI 69±16 g/m). Ejection fraction was comparable among the subgroups, but midwall fractional shortening was reduced in hypertensive subjects with LV hypertrophy (≈26%). Isovolumic relaxation time was increased in subjects with LV hypertrophy, whereas mitral wave A velocity was increased in hypertensive subjects with and without LV hypertrophy. Tissue Doppler imaging mitral annulus systolic (SM) and diastolic (EM) velocities were reduced in subjects with and without LV hypertrophy compared with normotensive subjects. There was a positive correlation between SM and EM (r=0.68; P<0.0001) and negative correlations between these 2 variables and LVMI (SM, r=−0.41; P=0.002; EM, r=−0.56; P<0.0001). Thus, reductions in mitral annulus systolic and diastolic velocities parallel increases in LV mass in hypertensive subjects, beginning at LV mass within the clinically defined normal values.