To assess the left ventricular regional relaxation abnormalities in patients with hypertrophic cardiomyopathy (HCM) by quantitative tissue velocity imaging (QTVI), Doppler echocardiography and QTVI were performed in HCM (n=10) and healthy subjects (n=11) at apical long-axis, two-chamber and four-chamber views. Regional early diastolic velocity (rVe) and regional atrial contraction (rVa) were measured at each segment of ventricular middle, basal and annular levels. Mean rVe and mean rVa at three levels as well as mean rVe/rVa ratio were calculated. Our results showed that transmitral inflow peak velocities during early diastole (E) and atrial contraction (A) were also measured and E/A ratio was calculated. The rVe of all left ventricular segments in HCM were lower than those in healthy subjects (P<0.05), but compared with healthy subjects majority of rVa in HCM were not different except inferior wall and anterior wall. E between HCM and healthy subjects was different (P=0.036), while mean rVe between them was significantly different (P<0.0001). Mean rVa and mean rVe/rVa of three levels were lower in HCM than in healthy subjects (P<0.05), but there were no differences in A and E/A between them (P=0.22, P=0.101). Left ventricular regional myocardial relaxation is reduced in HCM. Transmitral inflow E and A are influenced by preload, relaxation of myocardium and atrial contraction, etc., while rVe and rVa reflect myocardial relaxation function independently. QTVI is more sensitive and more accurate than conventional Doppler imaging for characterizingregional diastolic properties in HCM.
Cardiomyopathy, Hypertrophic/*physiopathology ; Cardiomyopathy, Hypertrophic/*ultrasonography ; Diastole ; Echocardiography, Doppler, Color/methods ; Hypertrophy, Left Ventricular/*physiopathology ; Hypertrophy, Left Ventricular/ultrasonography ; Ventricular Function, Left

OBJECTIVETo investigate the relationship between resting heart rate (RHR)and target organs damage in senile essential hypertension.

METHODSAll 206 elderly essential hypertensive patients (age: 60 - 85 years) were divided into three groups according to the levels of systolic blood pressure (SBP): SBP < 160 mm Hg, 160 mm Hg /= 180 mm Hg. Each of the groups mentioned above were divided into five groups according to the levels of RHR [RHR1 group: RHR < 65 beats/minute(bpm); RHR2: 65 bpm /= 80 bpm]. Electrocardiography, carotid ultrasonography, echocardiography, creatinine clearance rate (CCr) and quantitative test for 24 hours' urinary microalbuminuria (MAU) were performed.

RESULTS(1) Compared with RHR1-RHR4 groups, the RHR5 group showed with lower levels of MAU and left ventricular ejection fraction (LVEF) (P < 0.05 or P < 0.01). Compared with RHR1 and RHR2 groups, RHR5 or RHR4 group showed with higher levels of carotid intima-medial thickness (IMT) and carotid arterial diameter (CAD), lower CCr and MAU (P < 0.05 or P < 0.01). (2) The levels of IMT, CAD, LVMI, MAU were positively correlated to RHR (r = 0.312, 0.289, 0.630, 0.563, 0.576 respectively, all P < 0.01), however, the levels of LVEF, CCr were negatively correlated to RHR (r = -0.563, -0.510. all P < 0.01).

CONCLUSIONSTarget organ damage (TOD) seems not only related with PP, SBP, DBP, but also related with RHR in senile essential hypertension. RHR may be one of the important risk factors in TOD.

Aged ; Aged, 80 and over ; Blood Pressure ; Cardiovascular Diseases ; etiology ; Female ; Heart Rate ; Humans ; Hypertension ; complications ; diagnostic imaging ; physiopathology ; Hypertrophy, Left Ventricular ; Male ; Middle Aged ; Ultrasonography

BACKGROUND: The prevalence and clinical significance of white-coat hypertension (WCHT) and masked hypertension (MHT) are unknown in Koreans. Here we measure the frequency of WCHT and MHT in hypertensive subjects and identify the epidemiologic and/or clinical factors that predict it in Korean subjects. METHDOS: This study is a retrospective analysis of a random sample from February 2004 to October 2005. All patients had measurements of blood pressure (BP) in the clinic and 24-hour ambulatory blood pressure monitoring (ABPM). Subjects were classified into four groups on the basis of daytime ambulatory BP and clinic BP level: 1) Normotension (NT), 2) MHT, 3) WCHT, and 4) sustained hypertension (SHT). RESULTS: For all 967 patients, the mean clinic BP was 157.7+/-22.0/ 95.3+/-13.1 mmHg, and the mean daytime ambulatory BP was 136.4+/-15.0/ 86.2+/-10.7 mmHg. The NT, MHT, WCHT, and SHT groups consisted of 51 (5.3%), 55 (5.7%), 273 (28.2%), and 588 (60.8%) subjects, respectively. The left ventricular mass index was significantly higher in SHT than in the other groups, and was positively correlated with BP, especially ABPM. Compared with NT, the factors associated with MHT were younger age, male gender, higher BMI, clinic BP > or =130 mmHg, and alcohol consumption. Compared with SHT, the factors associated with WCHT were female gender, lower BMI, and clinic BP < 150 mmHg. CONCLUSIONS: WCHT and MHT were prevalent in the hypertensive population. ABPM was more predictive of target organ damage than clinic BP, and could be useful in identifying subjects at risk for WCHT and MHT.
Blood Pressure Monitoring, Ambulatory ; Female ; Health Status Indicators ; Heart Ventricles/*physiopathology/ultrasonography ; Humans ; Hypertension/*epidemiology/ultrasonography ; Hypertrophy, Left Ventricular/*physiopathology/ultrasonography ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the predictive value of the ambulatory blood pressure monitoring parameters on left ventricular hypertrophy (LVH) and carotid artery intima-media thickness (IMT) in the hypertensives.

METHODSWe evaluated 147 hypertensive patients who were never treated regularly before. All patients underwent ultrasound examinations of the heart and the IMT of carotid arteries. We classified them as LVH group (n = 45) or no LVH group (n = 102), and as IMT increased group (n = 52) or no IMT increased group (n = 95). The record of medical history, physical examination and 24 h ambulatory blood pressure monitoring (ABPM) were performed in all the patients. The biochemical parameters such as blood lipids, glucose and so on were tested. Then the data comparison was made.

RESULTS(1) There were no significant differences in clinical manifestations and biochemical parameters between the LVH and no LVH groups (P > 0.05). Age (68.3 +/- 6.2) year vs (65.6 +/- 5.8) year, male 75.6% vs 66.7%, body mass index (24.1 +/- 4.1) vs (23.8 +/- 4.7) (kg/m(2)), diabetes mellitus and(or) impaired glucose tolerance 40.0% vs 38.2%, angina pectoris 42.3% vs 38.9%, cerebral vascular diseases 19.2% vs 15.7%, total cholesterol (5.40 +/- 1.42) vs (5.28 +/- 1.46) mmol/L, triglycerides (1.80 +/- 1.02) vs (1.74 +/- 1.08) mmol/L, low-density lipoprotein cholesterol (4.03 +/- 1.43) vs (4.06 +/- 1.48) mmol/L, high-density lipoprotein cholesterol (1.00 +/- 0.30) vs (0.99 +/- 0.26) mmol/L. (2) The parameters of ABPM in LVH group were higher than those in no LVH group. There were significant differences (P < 0.05) in 24 h mean systolic blood pressure (140.7 +/- 14.1) vs (128.3 +/- 12.3) mm Hg, 24 h mean diastolic blood pressure (86.4 +/- 8.9) vs (81.6 +/- 9.3) mm Hg, daytime mean systolic blood pressure (142.8 +/- 13.9) vs (130.9 +/- 11.1) mm Hg, daytime mean diastolic blood pressure (86.9 +/- 8.8) vs (83.4 +/- 9.0) mm Hg, nighttime mean systolic blood pressure (129.0 +/- 13.2) vs (114.6 +/- 11.4) mm Hg, nighttime mean diastolic blood pressure (77.2 +/- 9.4) vs (67.5 +/- 8.1) mm Hg, 24 h pulse pressure (54.2 +/- 10.2) vs (46.9 +/- 9.6) mm Hg, daytime pulse pressure (55.9 +/- 10.5) vs (47.5 +/- 9.1) mm Hg, nighttime pulse pressure (51.8 +/- 10.7) vs (47.1 +/- 8.7) mm Hg, 24 h systolic blood pressure variance (8.4 +/- 2.0) vs (7.2 +/- 1.9), 24 h diastolic blood pressure variance (9.5 +/- 2.2) vs (8.0 +/- 2.1), the non-dipper rhythm of ambulatory blood pressure 55.6% vs 25.5%. (3) There were also no significant differences in clinical manifestations between the IMT increased and no IMT increased group (P > 0.05). While there were significant differences between the IMT increased and no IMT increased group in those parameters of ABPM (P < 0.05).

CONCLUSIONThere were more LVH or IMT increased persons in the hypertensives whose ABPM parameters were abnormal.

Aged ; Aged, 80 and over ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Carotid Arteries ; diagnostic imaging ; pathology ; Female ; Humans ; Hypertension ; diagnostic imaging ; pathology ; physiopathology ; Hypertrophy, Left Ventricular ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Ultrasonography