title: An effect of left ventricular hypertrophy on mild-to-moderate left ventricular diastolic dysfunction.
abstract: OBJECTIVE
  Left ventricular diastolic dysfunction (LVDD) is associated with a variety of medical conditions. Left ventricular hypertrophy (LVH) is one of the most common abnormalities that induce LVDD. However, it is unclear whether LVH is a predictor of future LVDD deterioration that leads to diastolic heart failure in patients who already have mild-to-moderate LVDD. In this study, we investigated the effect of LVH on LV diastolic function in mild-to-moderate LVDD patients.
  
  
  METHODS
  Of the patients with mild-to-moderate LVDD (Grade I and II) with preserved left ventricular ejection fraction (EF), 225 with LVH (LVH group) and 225 without LVH (non-LVH group) were consecutively selected. LVDD was defined by the abnormal patterns of Doppler mitral inflow and tissue Doppler. Left ventricular filling pressure (FP) was estimated by the following formula: 1.9 +1.24× [early mitral inflow velocity (E)/early mitral annular velocity (e')]. The Tei index was implemented to assess global (both systolic and diastolic) left ventricular function. Echocardiographic parameters for LVDD, such as isovolumic relaxation time (IVRT), were compared between the two groups.
  
  
  RESULTS
  FP and Tei index were significantly higher in the LVH group compared to the non-LVH group [15.68 mmHg vs. 14.07 mmHg, P < 0.0001, and 0.58 vs. 0.53, P < 0.003, respectively]. IVRT was significantly longer in the LVH group than in the non-LVH group [103.93 ± 23.93 vs. 95.94 ± 20.16, P < 0.0001].
  
  
  CONCLUSIONS
  In mild-to-moderate LVDD patients, both FP and the Tei index were significantly higher when LVH was present. This may suggest LVH as a possible predictor for the future development of severe LVDD and diastolic heart failure.
authors.affiliation: Department of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USA; Division of Hospital Medicine, Mayo Clinic Health System, Albert Lea/Austin, MN, USA. Electronic address: sharmakattel@gmail.com.
authors.forename: Sharma
authors.initials: S
authors.lastname: Kattel
authors.affiliation: Department of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USA.
authors.forename: Salim
authors.initials: S
authors.lastname: Memon
authors.affiliation: Department of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USA.
authors.forename: Keiko
authors.initials: K
authors.lastname: Saito
authors.affiliation: Division of Cardiology, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Jagat
authors.initials: J
authors.lastname: Narula
authors.affiliation: Department of Medicine, Sisters of Charity Hospital, University at Buffalo, Buffalo, NY, USA.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Left ventricular diastolic dysfunction; Left ventricular filling pressure; Left ventricular hypertrophy; Tei index