Relationship between left ventricular diastolic relaxation and systolic function in hypertension - The Hypertension Genetic Epidemiology Network (HyperGEN) Study

The relation of impaired left ventricular relaxation, as measured by prolon ged isovolumic relaxation time, to ventricular systolic function in hyperte nsion remains uncertain in population-based samples. In the Hypertension Ge netic Epidemiology Network (HyperGEN) Study, echocardiograms were analyzed in 1457 hypertensive participants without diabetes, greater than or equal t o2+ valvular regurgitation, or coronary disease. Impaired relaxation (isovo lumic relaxation time >100 ms) was present in 219 (15%) of the participants ; they were older and had higher arterial pressure than did those with norm al relaxation. Ventricular chamber size, wall thicknesses, mass, and relati ve wall thickness were greater, and stress-corrected midwall shortening and end-systolic stress/end-systolic volume index were lower with impaired rel axation than with normal relaxation time. Fractional shortening and ejectio n fraction did not differ between the groups. In logistic regression, the l ikelihood of prolonged isovolumic relaxation time decreased with higher str ess-corrected midwall shortening (odds ratio, 0.97%; 95% confidence interva l, 0.96 to 0.99), independently of age, heart rate, and ventricular mass. N either ejection fraction nor the end-systolic stress/end-systolic volume in dex was independently related to isovolumic relaxation time. In hypertensio n, impaired left ventricular relaxation parallels ventricular midwall dysfu nction but not systolic chamber function. Whether combined diastolic and sy stolic dysfunction identifies hypertensive patients at especially high risk of cardiovascular events requires further study.