Published Online
on April 3, 2006

A more recent version of this article appeared on May 1, 2006

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Submitted on December 12, 2005
Revised on January 1, 2006

Longitudinal Mitral Annulus Velocities Are Reduced in Hypertensive Subjects With or Without Left Ventricle Hypertrophy

Maria Cândida C. Borges; Roberta C. R. Colombo; José Geraldo F. Gonçalves; José de Oliveira Ferreira; and Kleber G. Franchini^*

From the Department of Internal Medicine (M.C.C.B., J.G.F.G., J.d.O.F.), School of Medicine, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil; and Departments of Internal Medicine (K.G.F.) and Nursing (R.C.R.C.), School of Medicine, State University of Campinas, Campinas, Sao Paulo, Brazil.

^* To whom correspondence should be addressed. E-mail: franchin{at}unicamp.br.

Abstract--Normotensive and hypertensive subjects with and without left ventricular (LV) hypertrophy (LV mass index [LVMI] >51 g/m^2.7) were examined by conventional echocardiography and tissue Doppler imaging of mitral annulus motion. The subgroups included nonobese normotensive subjects (n=16; age 51±9 years; 11 female; systolic blood pressure [SBP] 109±11 mm Hg, body mass index [BMI] 24±2.7 kg/m²; LVMI 32±5.5 g/m^2.7), nonobese hypertensive subjects without LV hypertrophy (n=16; age 54±12 years; 12 female; SBP 166±15 mm Hg; BMI 25±2.7 kg/m²; LVMI 42±5.5 g/m^2.7), and hypertensive subjects with LV hypertrophy (n=22; age 56±10 years; 10 female; SBP 181±19 mm Hg; BMI 26±2.3 kg/m²; LVMI 69±16 g/m^2.7). Ejection fraction was comparable among the subgroups, but midwall fractional shortening was reduced in hypertensive subjects with LV hypertrophy (26%). Isovolumic relaxation time was increased in subjects with LV hypertrophy, whereas mitral wave A velocity was increased in hypertensive subjects with and without LV hypertrophy. Tissue Doppler imaging mitral annulus systolic (S_M) and diastolic (E_M) velocities were reduced in subjects with and without LV hypertrophy compared with normotensive subjects. There was a positive correlation between S_M and E_M (r=0.68; P<0.0001) and negative correlations between these 2 variables and LVMI (S_M, r=-0.41; P=0.002; E_M, r=-0.56; P<0.0001). Thus, reductions in mitral annulus systolic and diastolic velocities parallel increases in LV mass in hypertensive subjects, beginning at LV mass within the clinically defined normal values.

Key words: cardiac function • myocardium • echocardiography

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