Impact of age on left ventricular geometry and diastolic function in elderly patients with treated hypertension

Toba, Ayumi; Kariya, Taro; Aoyama, Rie; Ishiyama, Taizo; Tsuboko, Yusuke; Takeda, Kazuhiro; Fujimoto, Hajime; Shimokado, Kentaro; Harada, Kazumasa

doi:10.1080/08037051.2017.1306422

Cited by 14 publications

(10 citation statements)

References 36 publications

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“…One of the reasons for such a large difference in cLVH prevalence may be aging. In general, older age is strongly correlated with LVH [17,18]. Although the mean age of patients was 42 years in the previous study that showed a lower prevalence of cLVH, it was 60.8 years in our study [16].…”

Section: Discussioncontrasting

confidence: 63%

“…The associations were not observed in elderly patients. Previous reports have shown that age is independently associated with LV concentric change [17,18] and recent basic studies have reported that several cellular and molecular changes, such as reduction of cardiomyocytes, replacement hypertrophy of residual cardiomyocytes, deposition of extracellular matrix, and extracellular fibrosis were observed in LV with aging [20,21]. These histological changes may lead LVs to undergo undesirable morphological changes, such as LVH.…”

Section: Discussionmentioning

confidence: 98%

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Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation

et al. 2021

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Background Concentric left ventricular hypertrophy (cLVH) is a common left ventricular geometric pattern in patients undergoing maintenance dialysis, including peritoneal dialysis (PD). The relationship between cLVH at PD initiation and the prognosis of patients remains unclear, however. This study aimed to investigate the impact of cLVH at PD initiation on patient survival and major adverse cardiovascular events (MACE). Methods The retrospective cohort study included 131 patients who underwent echocardiography during the PD initiation period. Based on echocardiographic measurements, cLVH was defined as a condition with increased LV mass index and increased relative wall thickness. The relationship between cLVH and the prognosis was assessed. Results Concentric LVH was identified in 29 patients (22%) at PD initiation, and patient survival, MACE-free survival and PD continuation were significantly reduced in the cLVH group compared with the non-cLVH group. In the Cox regression analysis, cLVH was demonstrated as an independent risk factor of mortality (HR [95%CI]: 3.32 [1.13–9.70]) for all patients. For patients over 65 years old, cLVH was significantly associated with mortality and MACE (HR [95%CI]: 3.51 [1.06–11.58] and 2.97 [1.26–7.01], respectively). Serum albumin at PD initiation was independently correlated with cLVH. Conclusions In our study, cLVH at PD initiation was independently associated with survival in all patients and with both survival and MACE in elderly patients. Evaluation of LV geometry at PD initiation might therefore help identify high-risk patients. Further studies involving larger numbers of patients are needed to confirm the findings from this study and clarify whether treatment interventions for factors such as nutrition status could ameliorate cLVH and improve patient outcomes.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 98%

Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation

et al. 2021

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“…Several studies have suggested a relationship between orthostatic hypotension and frailty, but there are no consistent results . Recently, we reported that aging itself increased left ventricular relative wall thickness independent of systolic BP level in hypertensive outpatients, and that subclinical orthostatic hypotension was attributable to decreased stroke volume, due to increased relative wall thickness and to arterial elasticity, measured as stroke volume per pulse pressure ratio, rather than autonomic nerve dysfunction . Orthostatic BP change and arterial stiffness measured by carotid‐femoral pulse wave velocity were also reported to be related …”

Section: Introductionmentioning

confidence: 82%

Orthostatic blood pressure rise is associated with frailty in older patients

Toba

Ishikawa

Suzuki

et al. 2019

Geriatrics Gerontology Int

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Aim: Orthostatic blood pressure (BP) can fall with reduced stroke volume and arterial elasticity. However, as the reason for orthostatic BP rise is unclear, we investigated the relationship of orthostatic BP rise with frailty in older patients. Methods:In 169 consecutive outpatients who visited the frailty clinic, we evaluated orthostatic BP and heart rate changes (i.e. in the sitting position, just after standing up, 1 min after standing and after sitting down). Frailty was evaluated using the Kihon Checklist (KCL) established by the Ministry of Health, Labor and Welfare.Results: The mean age was 77.4 AE 6.9 years, and 29% of patients had frailty with a KCL score ≥8. The systolic BP declined in both groups, but patients with frailty experienced a smaller decrease just after standing (−0.2 AE 10.3 vs −6.2 AE 11.5, P = 0.001). During standing for 1 min, elevation of systolic BP was greater in patients with frailty than in those without (8.4 AE 11.6 mmHg vs 3.2 AE 11.2 mmHg, P = 0.009). The difference in elevation of systolic BP remained significant, even after adjusting for confounding factors including systolic BP before standing (P = 0.013). In particular, the KCL score for motor function was significantly correlated with an elevation of orthostatic systolic BP after standing for 1 min, even after controlling for systolic BP before standing and confounding factors (P = 0.020). Conclusions:The elevation of systolic BP after standing for 1 min was greater in patients with frailty as diagnosed by the KCL score, especially in relation to reduced motor function.

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“…Previous research found that 10% of hypertension could cause a cardiac diastolic function decline [ 17 , 18 ]. Long-term hypertension, especially poorly controlled, could decrease the left ventricular compliance and increase stiffness [ 19 – 21 ]. AF could cause a variety of hemodynamic abnormalities such as rapid and irregular atrial activation impairing atrial contractile function, loss of regularity of atrioventricular conduction, and irregular ventricular contraction.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Renal Denervation on Cardiac Diastolic Function in Patients with Hypertension and Paroxysmal Atrial Fibrillation

Jiang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. Renal artery denervation (RDN) can treat hypertension and paroxysmal atrial fibrillation (PAF). Hypertension and PAF can affect cardiac diastolic function. The study aimed to evaluate the effect of RDN on cardiac diastolic function in patients with refractory hypertension and PAF. Methods. 190 consecutive patients with hypertension and PAF were recruited. The levels of NT-proBNP and metrics of echocardiography were measured before and after RDN in patients with refractory hypertension and PAF. The 190 patients were divided into the decreasing HR and nondecreasing HR group, the decreasing MAP and nondecreasing MAP group, the HFPEF group, and the normal diastolic function group, respectively. Results. Before RDN, the indices about cardiac diastolic function were out of the normal range. After RDN, the diastolic function improved in the indices of NT-proBNP, E/e′, e′. The diastolic function about the indices of NT-proBNP, E/e′, e′ was improved in the decreasing HR group, the decreasing mean arterial pressure (MAP) group, and the HFPEF group, correspondingly compared to the nondecreasing HR group, the non-decreasing MAP group, and the preoperative normal diastolic function group. In the multivariate analysis, the MAP and HR were the only two indicators significantly associated with the improvement of diastolic function. Conclusion. RDN could improve the diastolic function in patients with refractory hypertension and PAF. Patients with HFPEF could receive benefits through RDN. It was speculated that RDN improved the diastolic function mainly through decreasing HR and MAP.

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Impact of age on left ventricular geometry and diastolic function in elderly patients with treated hypertension

Abstract: Age was independently correlated with LV concentric/functional changes regardless of LV hypertrophy, suggesting that ageing is independently involved in the progression of LV remodelling.

Cited by 14 publications

References 36 publications

Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation

Prognostic significance of concentric left ventricular hypertrophy at peritoneal dialysis initiation

Orthostatic blood pressure rise is associated with frailty in older patients

The Effect of Renal Denervation on Cardiac Diastolic Function in Patients with Hypertension and Paroxysmal Atrial Fibrillation

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