Prediction of the progression of cardiac hypertrophy in middle-aged mild hypertensives.
To investigate the predictive value of exercise tests and diastolic function measurements for the progression of left ventricular hypertrophy, symptom-limited treadmill stress testing and echocardiography were performed before and after a follow-up period of 3.5 years in 47 mild hypertensive men aged 42 +/- 2 years. The men were classified into three groups by the progression of the left ventricular mass index (%LVMI) during the observation, i.e. (LVMI after follow-up) - (LVMI before follow-up)/(LVMI before follow-up). The high-progression group (n = 13) had a %LVMI exceeding mean +/- 2/3s.d. of all subjects; the low-progression group (n = 21) had a %LVMI within mean +/- 2/3s.d. and the non-progression group (n = 13) had a %LVMI less than mean -2/3s.d. At the beginning of the observation, age, blood pressure at rest, LVMI, ejection fraction, mean velocity of circumferential fibre shortening, peak shortening rate and systolic time intervals (ET/PEP, ratio of ejection time to pre-ejection period) were similar among the three groups. However, the high-progression group showed a higher systolic pressure at peak exercise, a lower peak filling rate and a longer time to peak filling rate (TPFR) as corrected by the R-R interval of the ECG. These data suggest that systolic pressure at peak exercise and echocardiographically assessed diastolic function are useful in predicting the progression of cardiac involvement in mild hypertension.
Kushiro
T
T
Department of Cardiology, Surugadai Nihon University Hospital.
Doba
N
N
Tomiyama
H
H
Ishii
T
T
Hinohara
S
S
Kajiwara
N
N
D000328:Adult; D006332:Cardiomegaly / Q000473:pathology*; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis