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
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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