Increased echocardiographic epicardial fat thickness and high-sensitivity CRP level indicate diastolic dysfunction in patients with newly diagnosed essential hypertension

摘要

BACKGROUND: Hypertension (HT) is one of the main conditions associated with left ventricular (LV) diastolic dysfunction. Epicardial fat tissue (EFT) serves as a source of a plenty of proinflammatory cytokines and is associated with increased cardiovascular events. The aim of the current study was to evaluate the relation among echocardiographically measured EFT thickness, systemic inflammation, and LV diastolic dysfunction in patients with essential HT. PATIENTS AND METHODS: The study included 135 newly diagnosed and untreated hypertensive outpatients. On the basis of conventional Doppler and tissue Doppler imaging-derived parameters, patients were divided into two groups: 60 patients with normal diastolic function and 75 patients with LV diastolic dysfunction. EFT thickness was measured from the parasternal long-axis view at end-systole and high-sensitivity C-reactive protein (hs-CRP) was assessed using the latex-enhanced immunoturbidimetric method. RESULTS: In patients with LV diastolic dysfunction, EFT thickness was significantly increased compared with the normal diastolic function group (7.9±1.7 vs. 6.3±1.5 mm; P<0.001, respectively). Serum hs-CRP level was also significantly higher in the LV diastolic dysfunction group (P<0.001) and was correlated with EFT thickness (r=0.442, P<0.001). In stepwise multivariate logistic regression analysis, EFT thickness (odds ratio 1.27, 95% confidence interval 1.12-1.43; P=0.006) and hs-CRP level (odds ratio 1.42, 95% confidence interval 1.18-1.72; P=0.003) emerged as independent positive predictors of LV diastolic dysfunction. CONCLUSION: In patients with newly diagnosed and untreated essential HT, increased EFT thickness and hs-CRP level are significantly related to impaired LV diastolic function independent from other factors, including age, waist circumference, and 24-h systolic blood pressure.