여성 고혈압 환자에서 부적절한 좌심실비대와 Framingham Risk Score 및 혈관경직도와의 관계
Relation of Inappropriate Left Ventricular Hypertrophy on Framingham Risk Score and Vascular Stiffness in Hypertensive Women
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Background: Although left ventricular hypertrophy (LVH) is a compensatory process to pressure overload, there are gender differences in left ventricular function and vascular stiffness in hypertension. We evaluated that inappropriate LVH was related with Framingham risk score (FRS) and vascular stiffness in hypertensive women. Methods: Total 226 hypertensive women consecutively underwent carotid ultrasound and echocardiography, from which LV mass (LVM), carotid intima-media thickness (IMT) and β-stiffness were measured. Inappropriate LVH was calculated by the ratio of observed LVM to the value predicted for sex, height and stroke work at rest and defined as > 128% of predicted. FRS was obtained using by National Cholesterol Education Program Adult Treatment Panel III. Results: Of 226 subjects, 59 subjects (26%) had inappropriate LVH. As compared with appropriate LVH, subject with inappropriate LVH showed older age, higher FRS, and IMT. Although LV ejection fraction was not different, diastolic parameters of E/A ratio and left atrial volume were significantly worse in inappropriate LVH group. Conclusions: The presence of inappropriate LVH in hypertensive women was strongly associated with higher FRS, decreased diastolic function and increased IMT, which might influence future cardiovascular events.
Abstract
Background: Although left ventricular hypertrophy (LVH) is a compensatory process to pressure overload, there are gender differences in left ventricular function and vascular stiffness in hypertension. We evaluated that inappropriate LVH was related with Framingham risk score (FRS) and vascular stiffness in hypertensive women. Methods: Total 226 hypertensive women consecutively underwent carotid ultrasound and echocardiography, from which LV mass (LVM), carotid intima-media thickness (IMT) and β-stiffness were measured. Inappropriate LVH was calculated by the ratio of observed LVM to the value predicted for sex, height and stroke work at rest and defined as > 128% of predicted. FRS was obtained using by National Cholesterol Education Program Adult Treatment Panel III. Results: Of 226 subjects, 59 subjects (26%) had inappropriate LVH. As compared with appropriate LVH, subject with inappropriate LVH showed older age, higher FRS, and IMT. Although LV ejection fraction was not different, diastolic parameters of E/A ratio and left atrial volume were significantly worse in inappropriate LVH group. Conclusions: The presence of inappropriate LVH in hypertensive women was strongly associated with higher FRS, decreased diastolic function and increased IMT, which might influence future cardiovascular events.
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