Change in diastolic left ventricular filling after one year of antihypertensive treatment: The @entity9886 Intervention For Endpoint Reduction in XXXX (LIFE) Study.

@entity1 @entity101 @entity1184 @entity73 @entity9886 @entity551 @entity4346 @entity2165 @entity1002
BACKGROUND: It is well established that @entity101 @entity1 with left ventricular (LV) @entity1184 have @entity73 . However, the impact of antihypertensive treatment and LV mass reduction on LV diastolic filling remains unclear. METHODS AND RESULTS: Echocardiograms were recorded in 728 @entity101 @entity1 with ECG-verified @entity4346 (Cornell voltage-duration or Sokolow-Lyon) at baseline and after 1 year of blinded treatment with either @entity9886 or @entity2165 -based regimen. @entity551 (BP) were reduced on average 23/11 mm Hg; isovolumic relaxation time and E/A ratio became more normal, and LV inflow deceleration time prolonged (all P<0.001). Directionally opposite changes in isovolumic relaxation time (IVRT) and deceleration time indicate improvement in active LV relaxation and passive chamber stiffness during early diastole. Prevalences of normal LV filling increased, abnormal relaxation and pseudonormalization decreased, and restrictive filling pattern remained unchanged (P<0.05). @entity1 with reduction in LV mass had smaller left atrial diameter, shortened IVRT, increased E/A ratio, and prolonged LV inflow deceleration time (all P<0.001). @entity1 without LV mass reduction had no change in diastolic filling parameters (P=NS). IVRT shortening was independently associated with reduction in LV mass. Increase in E/A ratio was independently associated with reduction in diastolic BP, and increase in the deceleration time was independently associated with reduced end-systolic relative wall thickness. CONCLUSIONS: Antihypertensive therapy resulting in LV mass or relative wall thickness regression is associated with significant improvement of diastolic filling parameters related to active relaxation and passive chamber stiffness compared with @entity1 without regression, independent of BP reduction; however, @entity1002 remain common.
