Relationship of diastolic function to new or persistent electrocardiographic left ventricular hypertrophy

Background: Persistence or development of Cornell product left ventricular hypertrophy (LVH) is associated with increased heart failure (HF) risk that is partly explained by greater LV systolic dysfunction. However, whether new or persistent Cornell product LVH during antihypertensive treatment is associated with worse LV diastolic function is unclear. Methods: Left ventricular diastolic function was examined in relation to year-3 ECG LVH in 377 hypertensive patients with a preserved LV ejection fraction (>45%) at year-3. Cornell product >2440 mm·ms defined ECG LVH. Results: In multivariate models adjusting for age, sex, change from baseline to year-3 systolic blood pressure, and baseline and change from baseline to year-3 Sokolow-Lyon voltage, persistent or new Cornell product LVH at year-3 remained associated with year-3 abnormal half filling time (OR 1.63, 95% CI 1.04-2.55 p = 0.034), with a trend toward higher odds of abnormal third filling time (OR 1.51, 95% CI 0.087 p = 0.087) and total filling time (OR 1.79, CI 0.98-3.27 p = 0.059). Conclusion: In hypertensive patients undergoing antihypertensive therapy, persistence or development of Cornell product ECG LVH at year-3 follow-up is modestly associated with LV diastolic dysfunction. These findings suggest that diastolic dysfunction may be a mechanism via which changing ECG LVH influences HF risk.