The Relationship of Carotid Arterial Stiffness and Left Ventricular Concentric Hypertrophy in Hypertension
Autor: | Ewa Kruszyńska, Stefania L Magda, Krzysztof Dudek, Dragos Vinereanu, Zbigniew Bociąga, Krystyna Łoboz-Grudzień, Joanna Jaroch, Andrea O. Ciobanu, Maria Florescu |
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Rok vydání: | 2016 |
Předmět: |
Carotid Artery Diseases
Male Medicine (miscellaneous) Hemodynamics Blood Pressure 030204 cardiovascular system & hematology Left ventricular hypertrophy 0302 clinical medicine Risk Factors Odds Ratio Pharmacology (medical) Pulse wave velocity Genetics (clinical) Ventricular Remodeling Middle Aged Pulse pressure Carotid Arteries Echocardiography Hypertension Cardiology Female Hypertrophy Left Ventricular Adult medicine.medical_specialty Concentric hypertrophy Pulse Wave Analysis General Biochemistry Genetics and Molecular Biology 03 medical and health sciences Vascular Stiffness Elastic Modulus Internal medicine Internal Medicine medicine Humans Aged Chi-Square Distribution Romania business.industry Ultrasonography Doppler medicine.disease Compliance (physiology) Cross-Sectional Studies Logistic Models Blood pressure Case-Control Studies Multivariate Analysis Reviews and References (medical) Arterial stiffness Poland business 030217 neurology & neurosurgery |
Zdroj: | Advances in Clinical and Experimental Medicine. 25:263-272 |
ISSN: | 1899-5276 |
Popis: | 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. Objectives 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]). Material and 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. |
Databáze: | OpenAIRE |
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