Circumferential versus longitudinal systolic function in patients with hypertension: a nonlinear relation.
BACKGROUND
Depressed circumferential midwall performance and impaired left ventricular (LV) longitudinal function are both early markers of LV systolic dysfunction in patients with hypertension. The relation between midwall and longitudinal indices in these patients has never been analyzed.


METHODS
In 126 patients with hypertension, midwall fractional shortening (mFS), stress-corrected mFS, M-mode left atrioventricular plane displacement, and tissue Doppler-derived peak mitral annular systolic velocity were determined.


RESULTS
Regression analysis showed that the relations of midwall indices to atrioventricular plane displacement and mitral annular systolic velocity were all nonlinear. Reductions in atrioventricular plane displacement or mitral annular systolic velocity within their higher ranges corresponded to relatively smaller decreases in mFS and stress-corrected mFS. Relative wall thickness was the strongest determinant of the relative efficiency of circumferential and longitudinal LV contraction.


CONCLUSIONS
The relation between circumferential midwall and longitudinal function in patients with hypertension is nonlinear and dependent on LV geometry. In these patients, systolic impairment occurs earlier in longitudinal than circumferential performance.
Ballo
Piercarlo
P
Cardiology Operative Unit, S. Andrea Hospital, La Spezia, Italy. pcballo@tin.it
Quatrini
Ilaria
I
Giacomin
Elisa
E
Motto
Andrea
A
Mondillo
Sergio
S
D000368:Aged; D003198:Computer Simulation; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008955:Models, Cardiovascular; D017711:Nonlinear Dynamics; D012189:Retrospective Studies; D013223:Statistics as Topic; D013599:Systole; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging