Usefulness of Subnormal Midwall Fractional Shortening in Predicting Left Ventricular Exercise Dysfunction in Asymptomatic Patients With Systemic Hypertension

Abstract We have recently shown that a subgroup of asymptomatic hypertensive patients exhibit subnormal left ventricular (LV) midwall fiber shortening at rest and that this finding predicts morbidity and mortality independently of age, blood pressure (BP), or the presence of LV hypertrophy. However, it is unknown whether abnormal midwall fractional shortening predicts either subnormal LV functional reserve or extracardiac damage in asymptomatic hypertensive patients. Accordingly, we compared radionuclide cineangiographic LV ejection fraction at rest and maximum exercise as well as clinical findings between 89 patients with normal and 16 patients with subnormal midwall fractional shortening by echocardiogram. Patients with low midwall fractional shortening were similar in gender, age, and systolic BP to those with normal shortening but had higher mean diastolic BP and body mass indexes (both p Radionuclide cineangiographic left ventricular (LV) ejection fraction at rest and maximum exercise were compared between 89 patients with normal and 16 patients with subnormal midwall fractional shortening by echocardiogram. Patients with subnormal midwall fractional shortening had higher LV mass and were more likely to have subnormal (