e490 Journal of Hypertension Vol 29, e-Supplement A, June 2011

Results: Although baseline values of E/E’ in H and C group were in normal less free time events in the LVH group. Concentric LVH has a worse progno-
limits (< 8), compared to controls H patients had higher E/E’ ratio at rest sis: RTI 3.99, 2.69 to 5.91). LVH with dipper profile increased events (IRR:
(5.5 ± 0.77 vs. 4,25 ± 0.83, p < 0.001). In C group E/E’ ratio did not increase 7.19 [3.29 to 15.74]); and non-dipper and riser profiles with LVH (12.18 [5.77
during exercise. Out of 55 hypertensive pts 38(69%) had no increase in E/E’ to 25.72] and 20,98 [9.81 to 44.91]) and without LVH (9.16 [4.15 to 20.24]
during exercise, while exercise E/E’ rised in 17(31%) pts (from 6.2 ± 0.48 to and 25.41 [9.31 to 72.75]) increase the risk. The Cox regression analysis
10.1 ± 1.06, p < 0.0001; difference 63%). The percentage of dyspnea as a showed that only the nocturnal BP decrease (OR [95% CI]: 0.97 [0.95 to 0.98],
primary reason for stopping exercise was similar in hypertensive pts with and p = 0.0007) and LVMI (OR [95% ] 1.02 [1.01 to 1.03], p < 0.0001) influenced
those without exercise increased E/E’. However, exercise duration was sig- in the patients prognosis.
nificantly shorter in hypertensive pts with than in pts without raised exercise
E/E’ (p < 0.025). Conclusions: The loss of the depth of blood pressure is the parameter that is
associated with poor CV prognosis in hypertensive patients. The presence of
Conclusion: In hypertensive patients with preserved global LV diastolic LVH determined a higher incidence of cardiovascular events. Although eccen-
function at rest, increased E/E’ during diastolic stress echocardiography may tric LVH is the most common, the concentric LVH is associated with increased
uncover those with subclinical diastolic dysfunction. cardiovascular risk.

PP.36.204 CAN THE SILENT MYOCARDIAL ISCHEMIA BE PP.36.206 ASSOCIATION BETWEEN EAS INDEX BY TISSUE
DETECTED IN ARTERIAL HYPERTENSIVE PATIENTS DOPPLER IMAGING AND VENTRICULAR STIFFNESS
WITH LEFT VENTRICULAR REMODELING? INDEX OR VENTRICULOARTERIAL INTERACTION
S. Gurgenyan, S. Vatinyan, K. Nikoghosyan. Institute f Cardiology, Yerevan- H. Sako, S. Miura, K. Saku. Fukuoka University Hospital, Fukuoka-Japan
Armenia
Objectives: Aortic stiffening contributes to cardiac afterload, left ventricular
Objective: Left ventricular (LV) hypertrophy often accompany with myocardial (LV) hypertrophy and substrate of cardiac function. We previously reported that
ischemia (MI). The aims of present study is to demonstrate that the symptoms of Eas Index by tissue doppler imaging (TDI) was associated with aortic stiffness
MI subsist in arterial hypertensive (AH) patients (pts) with LVH without clini- by transesophageal echocardiography and augmentation index. The purpose of
cally coronary arterial disease (CAD). this study was to evaluate the association between Eas index and LV elastance or
ventriculoarterial interaction.
Design and Method: We studied 43 pts with moderate AH (24 male and
19 female, mean age 52.1 ± 9.1 years). In all pts were performed 24-h ECG Methods and Results: We evaluated cardiac function by both conventional
Holter monitoring, in 40 - bicycle exercise ECG (begun with 25 W, increasing echocardiography and TDI velocities from 2 mitral annular sites in consecu-
by 25 W every 4 min), in 39 were evaluated the changes of wall motion score tive 300 patients. TDI velocities were quantified by Eas index of diastolic and
index (WMCI) at rest and at peak by the dobutamine stress-echocardiography systolic performance: e’ /(a’xs’). We also examined LV diastolic elastance
(SE), in 26 - the myocardial scintigraphy by use of 99mTc– pyrophosphate and in index (Ed), arterial elastance index (Ea), LV end-systolic elastance index
17 - 103TL and in 19 – coronary angiography. (Ees), ventricular- vascular coupling index (10xEa/Ees) and total stiffness
index (10xEdxEa/Ees). The Eas index was significantly correlated with Ed
Results: Fifty (34.8%) pts had an episode of SI in 24-h ECG Holter monitor- (r = -0.470, p < 0.0001), Ea (r = -0.198, p = 0.035) and total stiffness index
ing. Twenty (46.5.%) pts had > 0.1 mV of ST-segment depression and negative (r = -0.272, p = 0.003). However, Ees and ventricular-vascular coupling index
T wave in V5 and V6 in exercise ECG relative to the rest. The WMCI was were not associated with Eas index. Finally, multivariate logistic regression
observed in 9 (20.9%) pts at rest and in 27 (62.7%) – at peak (was deter- analysis showed that plasma levels of brain natriuretic peptide were most
mined by new wall motion abnormalities). In 22 (51.1%) pts the myocardial closely correlated with Ed (p = 0.004).
scintigraphy reveal the myocardial ischemic injuries. In 19 AH pts with LV
remodeling and SI parameters with clinic diagnosis of the attendant CAD were Conclusions: The Eas index for TDI may be a helpful tool for evaluating aortic
performed coronary angiography. In 15 pts were excluded CAD events and stiffness, cardiac afterload and diastolic LV function.
only in 4 of them was confirmed the CAD diagnosis.
Conclusions: In the absence of CAD the MI events in AH pts are presented PP.36.207 TISSUE DOPPLER INDEXES OF LEFT VENTRICULAR
as a result of LV remodeling and as possible is related with anomalies of SYSTOLIC FUNCTION IN RELATION TO THE
coronary microcirculation. Non-invasive diagnostic tests for detect of CAD PULSATILE AND STEADY COMPONENTS OF BLOOD
are not always adequate in AH pts. If diagnostic doubt preserves after the PRESSURE IN A GENERAL POPULATION
loaded test or a myocardial scintigraphy in AH pts coronary angiography can
be necessary. T. Kuznetsova1, W. Sakiewicz2, M. Kloch-Badelek3, J. Dhooge1, A. Ryabikov4,
K. Kunicka2, E. Swierblewska2, L. Thijs1, S. Malyutina4, K. Stolarz-
Skrzypek3, K. Kawecka-Jaszcz3, K. Narkiewicz2, J.A. Staessen1. 1University
PP.36.205 PROGNOSTIC VALUE OF LEFT VENTRICULAR of Leuven, Leuven-Belgium, 2Medical University of Gdansk, Gdansk- Poland,
3
HYPERTROPHY AND BLOOD PRESSURE Jagiellonian University Medical College, Cracow-Poland, 4Institute of Internal
VARIABILITY Medicine, Novosibirsk-Russia
S. Cinza Sanjurgo1, A. Hermida Ameijeiras2, Je López Paz2, M. Pena Seijo2, Objective: To our knowledge, no population study described the association of
G. Calvo González2, Ml Romero Miguez2, V. Martinez Durán2, A. Pascual the radial and longitudinal components of left ventricular (LV) strain with blood
Montes2, J.M. Paz Fernández2, C. Calvo Gómez2. 1Malpica Health Center, pressure (BP) in continuous analyses. We therefore investigated these associa-
Malpica-Spain, 2University Hospital Complex of Santiago, Santiago De tions in subjects randomly recruited from the general population in the frame-
Compostela-Spain work of the family-based European Project on Genes in Hypertension.
Introduction and Objectives: Left Ventricular Hypertrophy (LVH) is the earli- Design and Method: In 303 subjects (51.5% women; mean age, 43.0 year),
est manifestation of cardiac effect in hypertensive patients and is an independent using Tissue Doppler Imaging (TDI), we measured:1 end-systolic longitudi-
risk factor for cardiovascular complications. The objective of this study was to nal strain (mean, 21.0%) and peak systolic strain rate (SR) (1.29 1/s) from
determine the prognosis cardiovascular (CV) of hypertensive patients with LVH, the basal portion of the LV inferior and posterior free walls;2 and radial stain
based on the variability of blood pressure (BP) assessed by ABPM. (51.1%) and SR (3.40 1/s) of the LV posterior wall. Models included in addi-
tion to covariables and confounders both systolic and diastolic BPs or both
Methods: Cohort study in a sample of 432 hypertensive patients (218 women, pulse pressure (PP) and mean arterial pressure (MAP). Effect sizes were
55.5 years) and without cardiovascular disease (CV) prior. In all cases, clinical expressed per 1-SD increase in BP.
assessment and biological, ABPM-24h and echocardiography (Pen conven-
tion, with calculation of left ventricular mass index-LVMI, normalized for Results: Longitudinal strain (–0.72%; P = 0.03 and –0.76%; P = 0.005), but
body surface area and height-SC-AL). The monitoring of patients was per- not SR, decreased with diastolic BP and MAP. Radial strain (4.5% and –3.5%;
formed by review of medical history, recording the type of event (peripheral P ≤ 0.001) and SR (0.36 1/s and –0.21 1/s; P ≤ 0.03) independently increased
arterial disease, PAD, Coronary Disease-CD, heart failure-HF or stroke) and with systolic BP and decreased with diastolic BP. Accordingly, radial strain
recording the event date. (3.1%; P < 0.0001) and SR (0.22 1/s; P = 0.0007) increased with higher PP, but
were not related to MAP.
Results: Completed follow-up 405 patients (218 women, mean age 55.5
years). Patients with LVH have more events, IT = 5.99 compared to 3.06 for Conclusions: In the general population, BP is an independent determinant of
those without LVH (IRR: 1.96 [1.42 to 2.72]). The Kaplan-Meier curve shows LV systolic function as measured by TDI. Radial function increased with PP,