A perspective echo-Doppler study was performed in 1556 consecutive asymptomatic patients with grade 2-to-3 arterial hypertension aged 40-80 years enrolled in the SPHERE (multicenter proSPective study of ecHocardiography in hypERtEnsion) study. All patients had a LV ejection fraction (EF) ¡Ý 50 % and no history of heart failure or coronary artery disease. Advanced LVDD was identified by an average mitral-to-peak early diastolic annular ratio (E/e¡ä) ¡Ý 13. Less than advanced LVDD was identified by: 8 < E/e¡ä < 13 and left atrial volume index ¡Ý 34 ml/m2. Overall LVDD was present in 286 patients (18 % ): advanced in 128, less than advanced in 158. LV long-axis function, as assessed by average peak systolic annular velocity (hazard ratio [HR]: 0.54, p < 0.0001), mitral E/A ratio (HR: 3.20, p = 0.0009), age (HR: 1.05, p = 0.0087), body mass index (HR: 1.06, p = 0.037), and relative wall thickness (HR: 1.05, p = 0.050) were independent predictors of advanced LVDD. LV long-axis function (HR: 0.78, p < 0.0001), E/A ratio (HR: 2.35, p = 0.0032), LV end-diastolic volume index (HR: 1.04, p = 0.0035), and age (HR: 1.03, p = 0.018) were independently associated with overall LVDD, with a borderline contribution of LV mass index (HR: 1.01, p = 0.062).
An abnormal LV long-axis function was a powerful determinant of any LVDD in asymptomatic patients with arterial hypertension.