Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy.
J Hypertens. 2019 Oct;37(10):2041-2047. doi: 10.1097/HJH.0000000000002147.
In hypertensive patients, high left ventricular (LV) mass/end-diastolic volume ratio (LVM/EDV) is related to LV dysfunction and myocardial fibrosis.
We examined the ability of 3D-echo-derived LVM/EDV ratio in identifying early systolic and diastolic dysfunction in relation with LV concentric geometry in native hypertensive patients.
One-hundred and forty-four newly diagnosed, never treated hypertensive patients underwent 2D-echo, including computation of 2D-derived global longitudinal strain (GLS), and 3D-echo. The study population was divided into two groups: elevated 3D-LVM/EDV (≥1.23 in women and ≥1.22 in men), corresponding to LV concentric geometry (n = 50), and normal ratio (<1.23 in women and <1.22 in men) corresponding to LV normal or eccentric geometry (n = 94).
The two groups were comparable for sex, heart rate, BMI, and blood pressure (BP). Patients with elevated 3D-LVM/EDV ratio were older and had lower GLS (P < 0.001) than patients with normal LVM/EDV ratio. Transmitral E/A ratio (P < 0.0001) and e' velocity (P < 0.0001) were lower, and E/e' ratio (P < 0.0001) higher in patients with elevated LVM/EDV ratio. In the pooled population, LVM/EDV ratio was positively correlated to E/e' (r = 0.39, P < 0.0001) and negatively to GLS (r = -0.29, P < 0.001). By separate multilinear regression analyses, after adjusting for sex, age, heart rate, mean BP and BMI, LVM/EDV ratio - but not 2D-relative wall thickness - was independently associated with E/e' (β = 0.304, P = 0.003) and GLS (β = -0.501, P < 0.0001).
Three-dimensional echocardiographic assessment of LV concentric geometry allows identifying an early diastolic and longitudinal systolic dysfunction in native hypertensive patients. In particular, 3D-LVM/EDV ratio is independently associated with both E/e' ratio and GLS.
在高血压患者中，左心室（LV）质量/舒张末期容积比（LVM/EDV）较高与 LV 功能障碍和心肌纤维化有关。
我们研究了 3D 超声衍生的 LVM/EDV 比值在识别与 LV 向心性几何相关的原发性高血压患者早期收缩和舒张功能障碍方面的能力。
144 名新诊断、未经治疗的高血压患者接受了 2D 超声检查，包括计算 2D 衍生的整体纵向应变（GLS）和 3D 超声。研究人群分为两组：LVM/EDV 升高（女性≥1.23，男性≥1.22），对应 LV 向心性几何（n=50），LVM/EDV 比值正常（女性<1.23，男性<1.22），对应 LV 正常或偏心几何（n=94）。
两组在性别、心率、BMI 和血压（BP）方面无差异。LVM/EDV 比值升高的患者年龄较大，GLS 较低（P<0.001）。与 LVM/EDV 比值正常的患者相比，E/A 比值（P<0.0001）和 e'速度（P<0.0001）较低，E/e'比值（P<0.0001）较高。在汇总人群中，LVM/EDV 比值与 E/e'呈正相关（r=0.39，P<0.0001），与 GLS 呈负相关（r=-0.29，P<0.001）。通过单独的多元线性回归分析，在校正性别、年龄、心率、平均 BP 和 BMI 后，LVM/EDV 比值（而非 2D-相对壁厚度）与 E/e'（β=0.304，P=0.003）和 GLS（β=-0.501，P<0.0001）独立相关。
LV 向心性几何的 3D 超声评估可识别原发性高血压患者的早期舒张和纵向收缩功能障碍。特别是，3D-LVM/EDV 比值与 E/e'比值和 GLS 独立相关。
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