title: The Relationship of Carotid Arterial Stiffness and Left Ventricular Concentric Hypertrophy in Hypertension.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) and geometry patterns vary in different hemodynamic profiles The concentric hypertrophy (CH) pattern has been proved to have the worst prognosis.
  
  
  OBJECTIVE
  The aim of the study was to test the hypothesis that carotid artery stiffness, as a marker of vascular damage, is associated with CH, independently of other potential determinants such as demographic factors (age, sex, BMI), clinical parameters (smoking, diabetes, creatinine level) and hemodynamic variables (blood pressure, pulse pressure [PP]).
  
  
  METHODS
  The study involved 262 subjects (89 men): 202 patients with hypertension (153 untreated, 49 on medication), aged 55.7 ± 10 years, and 60 age-matched normal controls. The subjects were examined by echocardiography and carotid ultrasound with a high-resolution echo-tracking system. Based on the left ventricular mass index (LVMI) and relative wall thickness (RWT), the patients with hypertension were divided into four patterns of LVH and geometry: normal geometry (N, n = 57), concentric remodeling (CR, n = 48), concentric hypertrophy CH (n = 62) and eccentric hypertrophy (EH, n = 35). Intima-media thickness (IMT) and the parameters of arterial stiffness were also assessed using the β stiffness index (β), Young elastic modulus (Ep), arterial compliance (AC), one-point pulse wave velocity (PWVβ) and the wave reflection augmentation index (AI).
  
  
  RESULTS
  Univariate analysis showed that the following variables are significant in determining CH: β > 8.4, Ep > 136 kPa, PWVβ > 7.1 m/s, AI > 21.9%, systolic BP > 151 mm Hg, PP > 54, IMT > 0.56 and the presence of diabetes. However, by multivariate analysis only AI (OR 3.65, p = 0.003), PWVβ > 7.1 m/s (OR 2.86, p = 0.014), systolic BP (OR 3.12, p = 0037) and the presence of diabetes (OR 3.75, p = 0.007) were associated independently with the occurrence of CH.
  
  
  CONCLUSIONS
  Concentric hypertrophy in hypertension is strongly associated with carotid arterial stiffness and wave reflection parameters, independently of the influence of systolic blood pressure and diabetes.
authors.affiliation: Department of Cardiology, T. Marciniak Lower Silesian Hospital, Wrocław, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Jaroch
authors.affiliation: Department of Cardiology, T. Marciniak Lower Silesian Hospital, Wrocław, Poland.|Health Science Faculty, Wroclaw Medical University, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Łoboz-Grudzień
authors.affiliation: Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Stefania
authors.initials: S
authors.lastname: Magda
authors.affiliation: Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Maria
authors.initials: M
authors.lastname: Florescu
authors.affiliation: Department of Cardiology, T. Marciniak Lower Silesian Hospital, Wrocław, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Bociąga
authors.affiliation: Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Andrea O
authors.initials: AO
authors.lastname: Ciobanu
authors.affiliation: Department of Cardiology, T. Marciniak Lower Silesian Hospital, Wrocław, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kruszyńska
authors.affiliation: Institute of Machine Design and Operation, Wroclaw University of Technology, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Dudek
authors.affiliation: Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004452:Echocardiography; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011044:Poland; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012383:Romania; D018608:Ultrasonography, Doppler; D059289:Vascular Stiffness; D020257:Ventricular Remodeling
keywords: arterial stiffness; hypertension; left ventricular concentric hypertrophy