CoChat
Sign Up
Cited by 374Cardiovascular Function and Risk FactorsCardiac Imaging and DiagnosticsCardiovascular Health and Disease Prevention

Midwall Left Ventricular Mechanics: An Independent Predictor of Cardiovascular Risk in Arterial Hypertension

de Simone, Giovanni, Devereux, Richard B., Koren, Michael J., Mensah, George A., Casale, Paul N., Laragh, John H.·1996·Circulation
DOI 10.1161/01.cir.93.2.259
Open this paper in CoChat — free account

Abstract

Background An appreciable proportion of asymptomatic hypertensive patients have depressed left ventricular (LV) performance that is identified by midwall shortening/end-systolic stress relations but not by indexes that use endocardial shortening. It has not been established, however, whether depressed midwall ventricular performance has prognostic implications. Methods and Results Echocardiographic endocardial and midwall LV fractional shortening/circumferential end-systolic stress relations in 294 hypertensive patients were analyzed as predictors of the occurrence of cardiovascular morbid events that occurred in 50 patients (including 14 deaths) during a 10-year mean follow-up. Patients with initially lower midwall but not endocardial shortening, either in absolute terms or as a percentage of predicted from observed end-systolic stress, were more likely to suffer morbid events than those with initially normal values ( P <.004). Cardiovascular events occurred in 29 of 100 patients (29%) and death in 10 of 100 patients (10%) among those who were in both the two highest quartiles of LV mass index and the two lowest quartiles of midwall shortening, as opposed to 21 of 194 (11%) and 4 of 194 (2.1%) of the remaining patients (odds ratio, 3.4; 95% CI, 1.8 to 6.3; P <.0001; and odds ratio, 5.3; 95% CI, 1.6 to 17.3; P <.006, respectively). In logistic analysis, increasing age, high LV mass, high systolic blood pressure, and low values for an interaction term between LV mass index and midwall shortening independently predicted cardiovascular events (.04< P <.001); increasing age, low midwall LV shortening as a percentage of predicted, and high value of the interaction term predicted the occurrence of cardiac death (.004< P <.0002). Survival analysis controlling for age confirmed that low midwall shortening independently predicted cardiac morbidity or death, especially in the subgroup of patients with LV hypertrophy. Conclusions Depressed midwall shortening is a predictor of adverse outcome in arterial hypertension; the combination of higher LV mass and lower midwall shortening identifies individuals at markedly increased risk.

Integrity signals

Registry

Crossref · 10.1161/01.cir.93.2.259

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Obese subjects have generally been found to have subclinical contractile abnormalities when assessed with sensitive techniques.

    “Indeed, obese subjects have generally been found to have subclinical contractile abnormalities when assessed with the aforementioned techniques (21, 22, 71, 279, 377).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [71]

  • Increased endocardial shortening is a common finding in concentric LVH due to the relatively enhanced excursion of the endocardium in a thick-walled ventricle.

    “These results need to be interpreted with caution since increased endocardial shortening is a common finding in concentric LVH due to the relatively enhanced excursion of the endocardium in a thick-walled ventricle (21, 71).”

    From Cardiac remodeling in obesity (2008) · cites this paper as [71]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
de Simone, G., Devereux, R. B., Koren, M. J., Mensah, G. A., Casale, P. N., & Laragh, J. H.
Affiliations
  • From the Department of Medicine and Hypertension Center, The New York Hospital–Cornell Medical Center, New York, NY.
  • Weill Cornell Medical Center (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1996-01-15
Volume
93
Issue
2
Pages
259-265
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.93.2.259
OpenAlex
W1995781381
Cited by
374
References
37
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 12 · 2018: 7 · 2017: 10 · 2016: 11 · 2015: 13 · 2014: 16 · 2013: 12 · 2012: 14
FWCI
10.71
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (2p50hl018323-17)
  • National Heart, Lung, and Blood Institute (HL18323)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
left ventricular mechanics, left ventricular hypertrophy, hypertension, end-systolic wall stress, left ventricular mass, cardiovascular morbidity, cardiovascular mortality, prognosis, circumferential shortening
MeSH terms
Adult, Aged, Female, Humans, Hypertension, Male, Middle Aged, Prognosis, Risk, Ventricular Function, Left, Hypertrophy, Left Ventricular

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review