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Review
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Korean J Med. 2006;71(1):280-280.
- Influence of Left Ventricular Geometry on Exercise Capacity in Hypertensive Patients with Isolated Diastolic Dysfunction
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- Influence of Left Ventricular Geometry on Exercise Capacity in Hypertensive Patients with Isolated Diastolic Dysfunction
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1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
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- Abstract
- Objectives : Left ventricular (LV) geometrical change is associated with cardiac prognosis in hypertensive patients with or
without LV hypertrophy. Exercise capacity assessed by exercise treadmill test (TMT) can provide prognostic information. We
sought to assess whether LV geometry have an influence on exercise capacity in hypertensive patients with diastolic
dysfunction. Methods : One hundred none patients with essential hypertension, who performed symptom-limited TMT were
classified as having normal LV geometry (NG,n=40) or concentric LV geometry (CG,n=69). Patients with CG were further
categorized into moderate (n=55) or marked (n=14) CG group. Both conventional echocardiographic and tissue Doppler imaging
indexes were obtained. Results : There were no differences in age, sex and resting heart rate between NG and CG. Maximal
exercise time was longer in NG than in CG (617¡¾131 vs. 566¡¾155seconds,p<0.05). Late diastolic mitral annular velocity (A')
correlated with maximal exercise time in moderate and marked CG (r=0.296 and 0.559, respectively, all p<0.05), which was still
significant even after multivariate analysis, whereas no correlation was found in NG. Conclusions : LV geometry needs to be
considered in assessing exercise capacity in hypertensive patients with diastolic dysfunction. Atrial systolic function plays a
crucial role in maintaining exercise capacity in hypertensive patients with diastolic dysfunction, especially in those with increased
LV concentricity.
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