title: Left ventricular concentric geometry is associated with impaired relaxation in hypertension: the HyperGEN study.
abstract: OBJECTIVE
  We tested the hypothesis that abnormal left ventricular (LV) relaxation is associated with concentric LV geometry.
  
  
  RESULTS
  Doppler LV filling properties were studied in 1384 hypertensive participants without cardiovascular disease, from the HyperGEN population (731 women, 784 obese, 236 diabetic) and compared in four LV geometry groups; normal, concentric remodelling (3.5%), eccentric (23%), and concentric LV hypertrophy (4%), based on echocardiographic LV mass index (in g/m(2.7)). Abnormal LV relaxation was identified by European Society of Cardiology criteria in 275 subjects (20%). After accounting for significant confounders, E/A ratio and isovolumic relaxation time were not related to the presence of LV hypertrophy, but indicated abnormal relaxation when LV geometry was concentric (both P<0.0001). Deceleration time of E velocity was prolonged with LV hypertrophy (P<0.03), but the behaviour in relation to concentric LV geometry differed in the presence (prolonged) or absence (reduced) of LV hypertrophy (P=0.05), a difference independently related to the magnitude of both transmitral gradients and stroke volume (all P<0.05). Logistic regression showed that, compared with normal LV geometry, the odds of abnormal LV relaxation was 2.3-fold greater when LV geometry was concentric and that LV hypertrophy conferred a borderline higher risk than normal LV mass.
  
  
  CONCLUSIONS
  In hypertensive individuals without prevalent cardiovascular disease from a multi-ethnic population-based sample, delayed LV relaxation is independently associated with concentric LV geometry.
authors.affiliation: Weill Medical College of Cornell University, New York, NY, USA. simogi@unina.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.forename: Dalane W
authors.initials: DW
authors.lastname: Kitzman
authors.forename: Marcello
authors.initials: M
authors.lastname: Chinali
authors.forename: Albert
authors.initials: A
authors.lastname: Oberman
authors.forename: Paul N
authors.initials: PN
authors.lastname: Hopkins
authors.forename: Dabeeru C
authors.initials: DC
authors.lastname: Rao
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology / Q000503:physiopathology; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009765:Obesity / Q000473:pathology / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology