Hypertensive Ventricular Remodeling And Vascular-Ventricular Stiffening

Background:The prevalence of heart failure presenting in the setting of preserved ejection fraction was increasing year by year. While it has not been clear that the presence of early vascular dysfunction in the setting of subclinical ventricular dysfunction and the potential procedure of vascular-myocardium stiffness. Hypertensive cardiac remodeling is characterized by hypertrophy, small vessel disease, myocyte disarray, and increased interstitial fibrosis, which can be divided as normal geometry, concentric remodeling, concentric hypertrophy and eccentric hypertrophy by echocardiography. It has been well established that hs-TnT is a specific and high-sensitivity marker in acute coronary syndromes. On the other hand, the researches about values of serum concentrations of hs-TnT in subjects with hypertension in the absence of significant coronary stenosis were limited. Methods:Eligible study subjects were 349 hypertensive subjects and 104 controlled subjects who participated in a community-based survey, underwent the clinical assessment, the examination of arterial stiffness, left ventricular(LV) echocardiography and the test of biochemistry parameters including serum homocysteine and hs-TnT. All participants were divided into four groups according to hypertension and LV diastolic function.159 hypertenive subjects not taking anti-hypertensive drugs and 72 healthy subjects with similar age and gender were included in the researches of hs-TnT in hypertensive cardiac remodeling. Results:Stiffness parameter correlated with the LV diastolic function (E/Em). Multiple regression analysis revealed that arterial stiffness was an early indicator of LV diastolic dysfunction (β=0.189, P<0.001). Homocysteine was independently related to arterial stiffness and LV filling pressure when age and gender were accounted for. The hs-TnT level were positively correlated to left ventricular mass index(r=0.344; P=0.027), and diastolic function [E/Em (r=0.437;P<0.001)], and negatively correlated to systolic function(mid-wall fractional shortening). Hs-TnT was independently related to age, gender, eGFR, E/Em and left ventricular mass index on multiple analysis in the whole participation. Conclusions:Increased arterial stiffness was an independent predictor of LV diastolic function. Enhanced arterial stiffness associated with LV diastolic dysfunction based on similar risk factors. Homocysteine modulated both arterial stiffening and ventricular dysfunction. An increase in hs-TnT levels could be a reliable biomarker of cardiac remodeling and function in hypertension, as an indicator of subclinical ongoing cardiomyocyte damage.