The DT was lower in the eccentric hypertrophy group, as compared with that of the other groups. Table 3 Doppler indices of the left ventricular diastolic function of the patient groups Open in a separate window The data is presented as the meanSD. were increased in the eccentric and concentric hypertrophy groups. Compared with the patients with normal Fmoc-Val-Cit-PAB geometry, the patients with eccentric and concentric hypertrophy exhibited a significant higher value for the left atrial volume index. The ratio of FAZF the transmitral inflow velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Conclusion This study demonstrates that in a patient populace with hypertension and who are without systolic dysfunction, the left atrial volume index and the E/E’ exhibited a progressive worsening of the left ventricular diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. strong class=”kwd-title” Keywords: Ventricular remodeling, Left atrium, Doppler echocardiography, Hypertension Introduction The cardiac adaptation of the left ventricle to hypertension may occur in four different geometric patterns, as based on the left ventricular mass index (LVMI) and the relative wall thickness (RWT). The left ventricular geometric patterns include the normal geometry with the normal LVMI and RWT, concentric remodeling with the normal LVMI and the increased RWT, eccentric hypertrophy with the increased LVMI and the normal RWT, and concentric hypertrophy with increases in both the LVMI and RWT.1),2) Studies that have grouped hypertensive patients by these geometric patterns have revealed distinctive profiles of the blood pressure,3) the hemodynamics4) and the prognosis.5) Simone et al.6) have also reported that this Doppler indices of abnormal relaxation were more impaired in the presence of concentric left ventricular geometry and this was assessed by using the diastolic filling pattern of the mitral circulation. However, it is not well understood whether the left ventricular geometry is usually associated with the modern diastolic parameters, such as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry around the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods Study populace Using our database of the patients who underwent transthoracic echocardiography between January 2004 and December 2007, we selected 181 patients, among all the hypertensive patients, for analysis and these 181 patients’ clinical and echocardiographic data were readily available. Patients were defined as being hypertensive if they experienced a history of antihypertensive therapy, an office systolic blood pressure 140 mmHg or a diastolic blood pressure 90 mmHg. The prior medications consisted of calcium antagonists, diuretics, beta-blockers, angiotensin transforming enzyme inhibitors and angiotensin receptor blocker. We excluded all the individuals with established cardiovascular diseases such as myocardial infarction, angina, coronary bypass grafting and congestive heart failure, atrial fibrillation, significant aortic and/or mitral valve disease, or an ejection portion 50%. Based on the LVMI and the RWT, the patients were categorized into four groups: the normal geometry group, the concentric remodeling group, the eccentric hypertrophy group and the concentric hypertrophy group. Echocardiography Transthoracic echocardiography was performed Fmoc-Val-Cit-PAB using a commercially available imaging ultrasound system (Sonos 5500, Hewlett-Packard Co., Palo Alto, CA, USA) with harmonic imaging. The measurements were made according to the recommendations of the American Society of Echocardiography and using the leading edge to leading edge convention.6) The left ventricular internal dimensions, the septal thickness and the left ventricular posterior wall thickness were measured at end-diastole as defined by the onset of the QRS complex. The Fmoc-Val-Cit-PAB RWT was calculated as follows: 2left ventricular posterior wall thickness/left ventricular end-diastolic dimension. A value more than 0.44 was defined as abnormal. The left ventricular mass was calculated using the formula developed by Devereux et al.8): 0.801.04 (left ventricular end-diastolic diameter+left ventricular septal thickness+posterior wall thickness)3-(left ventricular end-diastolic diameter)3+0.6. The LVMI was indexed for the body surface area. Left ventricular hypertrophy was to be considered present when the LVMI was 125 g/m2 in men or 110 g/m2 in women.9) The combination of the LVMI and RWT defined the four left ventricular geometric patterns: normal geometry (a normal LVMI and a normal RWT), concentric remodeling (a normal LVMI and an increased RWT), concentric hypertrophy (an increased LVMI and an increased RWT) and eccentric hypertrophy (an increased LVMI and a normal RWT).1) The left atrial diameter was measured by the two-dimensional.There were no significant differences among any of the four groups in terms of the A velocity, the isovolumic relaxation time and the E’ velocity. were reduced in the concentric remodeling group, whereas the left ventricular end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. Conclusion This study demonstrates that in a patient population with hypertension and who are without systolic dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy. strong class=”kwd-title” Keywords: Ventricular remodeling, Left atrium, Doppler echocardiography, Hypertension Introduction The cardiac adaptation of the left ventricle to hypertension may occur in four different geometric patterns, as based on the left ventricular mass index (LVMI) and the relative wall thickness (RWT). The left ventricular geometric patterns include the normal geometry with the normal LVMI and RWT, concentric remodeling with the normal LVMI and the increased RWT, eccentric hypertrophy with the increased LVMI and the normal RWT, and concentric hypertrophy with increases in both the LVMI and RWT.1),2) Studies that have grouped hypertensive patients by these geometric patterns have revealed distinctive profiles of the blood pressure,3) the hemodynamics4) and the prognosis.5) Simone et al.6) have also reported that the Doppler indices of abnormal relaxation were more impaired in the presence of concentric left ventricular geometry and this was assessed by using the diastolic filling pattern of the mitral flow. However, it is not well understood whether the left ventricular geometry is associated with the modern diastolic parameters, such as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods Study population Using our database of the patients who underwent transthoracic echocardiography between January 2004 and December 2007, we selected 181 patients, among all the hypertensive patients, for analysis and these 181 patients’ clinical and echocardiographic data were readily available. Patients were defined as being hypertensive if they had a history of antihypertensive therapy, an office systolic blood pressure 140 mmHg or a diastolic blood pressure 90 mmHg. The prior medications consisted of calcium antagonists, diuretics, beta-blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blocker. We excluded all the individuals with established cardiovascular diseases such as myocardial infarction, angina, coronary bypass grafting and congestive heart failure, atrial fibrillation, significant aortic and/or mitral valve disease, or an ejection fraction 50%. Based on the LVMI and the RWT, the patients were categorized into four groups: the normal geometry group, the concentric remodeling group, the eccentric hypertrophy group and the concentric hypertrophy group. Echocardiography Transthoracic echocardiography was performed using a commercially available imaging ultrasound system (Sonos 5500, Hewlett-Packard Co., Palo Alto, CA, USA) with harmonic imaging. The measurements were made according to the.