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41 Background Hypertensive patients can develop subtle myocardial dysfunction despitea normal LVEF and absence in LVH ADDIN ENCITE ADDIN ENCITEDATA HYPERLINK l ENREF189 o Lamb 1999 227 189 HYPERLINK lENREF190 o Ren 1994 228 190 Diastolic dysfunction mayoccur early in hypertensive heart disease prior to detectable LVH orsystolic dysfunction ADDIN ENCITE ADDIN ENCITEDATA HYPERLINKl ENREF191 o Slama 2002 241 191 HYPERLINK l ENREF192o Conrad 1995 242 192 A comprehensive CMR evaluation ofregional and diffuse myocardial fibrosis in a typical cohort ofhypertensive patients with abnormal diastolic function has not beenfully described This study was undertaken for the following aims 1to assess and quantify diffuse myocardial fibrosis in hypertensivepatients with normal LVEF LGE and abnormal diastolic function using CMRrelaxometry mapping 2 to examine the relationship between myocardialfibrosis to LV diastolic performance and clinical manifestations using2D speckle tracking analysis and tissue Doppler imaging 42 MethodsTwenty hypertensive patients were prospectively referred from thehospital hypertension clinic Inclusion criteria were longstandinghypertension 1 year blood pressure adequately controlled with theuse of 3 antihypertensive medications systolic 160 mmHg diastolic100 mmHg All subjects had normal left ventricular systolic functionby Simpsons biplane method and abnormal diastolic function by Dopplerassessment grade I and II according to ASE criteria ADDIN ENCITEEndNoteCiteAuthorNaguehAuthorYear2009YearRecNum243RecNumDisplayText193DisplayTextrecordrec-number243rec-numberforeign-keyskey appENdb-id5xszt2f0isafdsexad85f5vcr9pv9xd59xfz243keyforeign-keysref-type nameJournalArticle17ref-typecontributorsauthorsauthorNagueh SherifFauthorauthorAppleton Christopher PauthorauthorGillebertThierry CauthorauthorMarino Paolo NauthorauthorOh JaeKauthorauthorSmiseth Otto AauthorauthorWaggoner AlanDauthorauthorFlachskampf Frank AauthorauthorPellikkaPatricia AauthorauthorEvangelisaArturoauthorauthorscontributorstitlestitleRecommendationsfor the Evaluation of Left Ventricular Diastolic Function byEchocardiographytitlesecondary-titleEuropean Journal ofEchocardiographysecondary-titletitlesperiodicalfull-titleEuropean Journal ofEchocardiographyfull-titleperiodicalpages165-193pagesvolume10volumenumber2numberdatesyear2009yeardatesurlsrelated-urlsurlhttpehjcimagingoxfordjournalsorgcontent102165shorturlrelated-urlsurlsrecordCiteEndNote HYPERLINK lENREF193 o Nagueh 2009 243 193 at baselineechocardiography prior to recruitment Patients were excluded if they had diabetes dyslipidemia cardiacarrhythmia documented coronary artery disease previous myocardialinfarction by history or presence of segmental wall motionabnormalities or presence of LGE on MRI indicative of previousmyocardial infarction LVEF 55 more than mild valvular dysfunctionrenal impairment estimated creatinine clearance 60 mlmin pregnancyclaustrophobia or presence of non-MRI
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