Cardiovascular Features of Heart Failure With Preserved Ejection Fraction Versus Nonfailing Hypertensive Left Ventricular Hypertrophy in the Urban Baltimore Community

摘要: Objectives The purpose of this study was to identify cardiovascular features patients with heart failure preserved ejection fraction (HFpEF) that differ from those in individuals hypertensive left ventricular hypertrophy (HLVH) similar age, gender, and racial background but without failure. Background Heart often develops HLVH involves multiple abnormalities. Clarification changes most specific HFpEF may help elucidate underlying pathophysiology. Methods A cross-sectional comparing (n 37), subjects HF 40), normotensive control LVH 56). All had an EF 50%, sinus rhythm, insignificant valvular or active ischemic disease, groups were matched for ethnicity. Comprehensive echoDoppler pressure analysis performed. Results predominantly African-American women hypertension, LVH, obesity. They vascular systolic-ventricular stiffening abnormal diastolic function compared the subjects. However, these parameters either individually combined similarly group poorly distinguished between groups. quantitatively greater concentric estimated mean pulmonary artery wedge (20 mm Hg vs. 16 Hg) shorter isovolumic relaxation time than group. also atrial dilation/dysfunction unlike total epicardial volume. product LV mass index maximal (LA) volume best identified (84% sensitivity, 82% specificity). Conclusions In urban, principally African American, cohort, share many abnormalities systolic, diastolic, nonfailing display accentuated LA dilation/failure. These latter factors clarify pathophysiology define important population clinical trials. (J Am Coll Cardiol 2007;49:198‐207) © 2007 by American College Cardiology Foundation