Altered Left Ventricular Geometry and Torsional Mechanics in High Altitude-Induced Pulmonary Hypertension: A Three-Dimensional Echocardiographic Study

2018 ◽  
Vol 31 (3) ◽  
pp. 314-322 ◽  
Author(s):  
Bart W. De Boeck ◽  
Aurel Toma ◽  
Stephanie Kiencke ◽  
Christoph Dehnert ◽  
Stefanie Zügel ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
High Altitude ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Geometry ◽  
Echocardiographic Study

Abstract P092: Longitudinal Impact Of Blood Pressure On Left Ventricular Geometry In The Hispanic Community Health Study/Study Of Latinos: Echocardiographic Study Of Latinos (Echo-SOL) Ancillary Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Jennifer McLeod ◽  
Barry E Hurwitz ◽  
Daniela Sotres-Alvarez ◽  
Mayank M Kansal ◽  
Katrina Swett ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular ◽  
Health Study ◽  
Left Ventricular Geometry ◽  
Longitudinal Impact ◽  
Ventricular Geometry ◽  
Concentric Hypertrophy ◽  
Echocardiographic Study ◽  
Eccentric Hypertrophy ◽  
Latino Adults

Introduction: Abnormal left ventricular geometry (LVG) is an independent predictor of cardiovascular mortality. We assessed the longitudinal transitions of LVG among Hispanic/Latino adults. Methods: Echo-SOL provided serial 2D echocardiograms of Hispanic adults. Each subject was identified as hypertensive or normotensive and categorized into four LVG patterns: normal, concentric remodeling (CR), concentric hypertrophy (CH), or eccentric hypertrophy (EH). Hypertensive adults were stratified on whether they maintained blood pressure (BP) control (<140/90mmHg) by visit 2. The normotensive adults were stratified on whether they developed incident hypertension (HTN) by visit 2. Logistic regression was used to evaluate the outcome of normal vs. abnormal LVG at visit 2 adjusting for age, sex, and follow-up time. Results: There were 1818 adults at visit 1 (mean age 56 years; 42.6% male, 44.7% hypertensive), with 1643 obtaining serial echocardiograms an average of 4.3 years later. At visit 1, LVG was distributed as follows: normal, 65.3%; CR, 30.6%, CH 3.1%, and EH 1.1%. Among hypertensive adults at visit 1, 59.7% had normal LVG and 34.1% had CR. By visit 2, there was a progression from normal LVG to CR among those with and without BP control; CR prevalence increased to 58.5% and 55.2%, respectively (Fig. 1). For visit 1 hypertensive adults, the incidence of abnormal LVG did not differ with regards to BP control (adjusted OR 1.1, 95% CI: 0.7-1.7). Among normotensive adults at visit 1, 69.8% had normal LVG. If they remained normotensive by visit 2, this prevalence decreased to 52.2%. If they developed HTN, there was an associated progression toward abnormal geometry (adjusted OR 2.5, 95% CI: 1.4-4.2), with the majority (59.2%) demonstrating a CR phenotype. Conclusion: Our findings suggest that BP control to 140mmHg is not adequate to prevent progressive LV remodeling among Hispanic/Latino adults. Further study is needed to understand this maladaptive process and how it contributes to cardiovascular disease in this population.

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