(Hypertension. 1997;30:777-781.)
© 1997 American Heart Association, Inc.
Articles |
Systolic Function in Hypertensive Men With Concentric Remodeling
From the Divisions of Cardiology of the University of Massachusetts Medical Center (D.B.S., G.P.A.), Worcester, and Georgetown University Hospital (J.S.G.), Washington, DC, and the Cooperative Studies Program, Department of Veterans Affairs (D.W.W., D.J.R., B.J.M.).
Correspondence to Gerard P. Aurigemma, MD, University of Massachusetts Medical Center, 55 Lake Ave North, Worcester, MA 01655. E-mail gerard.aurigemma{at}banyan.ummed.edu
Abstract Hypertensive patients with concentric remodeling
(relative wall thickness 
0.45 and normal left ventricular
[LV] mass index) may have poor outcomes. It is unclear whether
systolic function abnormalities, shown to be present in
some patients with concentric LV hypertrophy (increased LV
mass index and relative wall thickness 0.45), are also present in
patients with concentric remodeling. To assess LV pump, chamber, and
myocardial function in hypertensive men with concentric remodeling,
clinical and echocardiographic data of 118 hypertensive
men with concentric remodeling were compared with data from 104
hypertensive men with normal relative wall thickness and normal LV mass
index. Chamber function was assessed by relating endocardial fractional
shortening to end-systolic circumferential stress, myocardial
function was assessed by relating midwall fractional shortening to
circumferential stress, and pump performance was assessed by
stroke volume (Teichholz method). Compared with hypertensive men with
normal relative wall thickness, concentric-remodeling patients had
lower stroke volume (84±20 versus 111±20 mL, P<.001).
Endocardial shortening was no different between the two groups (38±7%
versus 40±7%, P=NS), but midwall shortening was lower in
patients with concentric remodeling (20±3% versus 22±3%,
P<.001), despite lower end-systolic stress (81±25
versus 117±37 g/cm2, P<.001). Endocardial and
midwall stress-shortening regression plots classified 28% and 42%,
respectively, of the concentric remodeling patients below the fifth
percentile of hypertensive patients with normal geometry. These data
indicate that indexes of chamber and myocardial function are lower than
those observed in hypertensive patients with normal geometry. Thus,
indices of chamber, myocardial, and pump performance indicate
potential abnormalities in systolic function in men with
concentric remodeling.
Key Words: hypertrophy • systolic function • left ventricular mass
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