title: Echocardiographic evaluation of cardiac structure and function in elderly subjects with isolated systolic hypertension.
abstract: One hundred four participants in the Systolic Hypertension in the Elderly Program (SHEP) trial (mean age 71 +/- 6 years) were examined by Doppler echocardiography to gain information on the cardiac structural and functional alterations in isolated systolic hypertension. Participants had a systolic blood pressure greater than 160 mm Hg with diastolic blood pressure less than 90 mm Hg and were compared with 55 age-matched normotensive control subjects. Left ventricular mass index was significantly higher in the participants than in the normotensive subjects (103 +/- 28 versus 87 +/- 23 g/m2, p = 0.0014) and 26% of the participants met echocardiographic criteria for left ventricular hypertrophy compared with 10% of normotensive subjects. Left atrial index was also greater in participants than in normotensive subjects (2.26 +/- 0.32 versus 2.11 +/- 0.24 cm/m2, p = 0.005) and 51% of participants had left atrial enlargement. Doppler measures of diastolic filling were significantly different between the two groups, with peak atrial velocity higher (76 +/- 17 versus 69 +/- 17 cm/s, p = 0.02) and ratio of peak early to atrial velocity lower (0.76 +/- 0.23 versus 0.86 +/- 0.22, p = 0.0124) in participants. There was no correlation between left ventricular mass index and Doppler measures of diastolic function, but relative wall thickness correlated significantly with peak atrial velocity (r = 0.22, p = 0.016) and peak early to peak atrial velocity ratio (r = 0.24, p = 0.007). There was no difference in M-mode ejection phase indexes of systolic performance (shortening fraction and peak velocity of circumferential fiber shortening) between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Internal Medicine, University Hospital, St. Louis University School of Medicine, Missouri.
authors.forename: A C
authors.initials: AC
authors.lastname: Pearson
authors.forename: C
authors.initials: C
authors.lastname: Gudipati
authors.forename: D
authors.initials: D
authors.lastname: Nagelhout
authors.forename: J
authors.initials: J
authors.lastname: Sear
authors.forename: J D
authors.initials: JD
authors.lastname: Cohen
authors.forename: A J
authors.initials: AJ
authors.lastname: Labovitz
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D006332:Cardiomegaly / Q000000981:diagnostic imaging; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D008297:Male; D013599:Systole / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology