Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 2, March-April, p. 263–272

doi: 10.17219/acem/34654

Publication type: original article

Language: English

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The Relationship of Carotid Arterial Stiffness and Left Ventricular Concentric Hypertrophy in Hypertension

Joanna Jaroch1,A,B,C,D,E,F, Krystyna Łoboz-Grudzień1,2,A,B,C,D,E,F, Stefania Magda3,A,B,C,D,E,F, Maria Florescu3,A,B,C,D,E,F, Zbigniew Bociąga1,A,B,C,D,E,F, Andrea O. Ciobanu3,A,B,C,D,E,F, Ewa Kruszyńska1,A,B,C,D,E,F, Krzysztof Dudek4,A,B,C,F, Dragos Vinereanu3,A,B,C,D,E,F

1 Department of Cardiology, T. Marciniak Lower Silesian Hospital, Wrocław, Poland

2 Health Science Faculty, Wroclaw Medical University, Poland

3 Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

4 Institute of Machine Design and Operation, Wroclaw University of Technology, Poland

Abstract

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.
Conclusion. 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.

Key words

hypertension, left ventricular concentric hypertrophy, arterial stiffness

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