1. ¹Department of Internal Medicine, University of Palermo, Palermo, Italy
2. ²Unit of Clinical Methodology, Epidemiological and Statistics, National Relevance Hospital Trust, Civico e Benfratelli, Palermo, Italy

Correspondence: Professor G Parrinello, Department of Internal Medicine, Istituto di Clinica Medica, Piazza delle Cliniche 2, University od Palermo, Palermo 90127, Italy. E-mail: gaspare.parrinello@unipa.it

Received 6 November 2004; Revised 21 February 2005; Accepted 22 February 2005; Published online 21 April 2005.

Abstract

This study has been designed to evaluate the relationship among transforming growth factor 1 (TGF1) and some measurements of diastolic function in a population of hypertensive subjects with normal left ventricular ejection fraction. We studied 67 hypertensive outpatients who according to their BMI levels were subdivided into three groups: lean (L), overweight (OW) and obese (OB) hypertensives (HT). Circulating TGF1 and M- and B-mode echocardiography was determined. All hypertensives were further subgrouped, according to European Society of Cardiology Guidelines, into two subsets of patients with normal diastolic function or with diastolic dysfunction. Prevalence of left ventricular hypertrophy (LVH) was determined in all the groups. TGF1, left ventricular mass (LVM), LVM/h^2.7, E-wave deceleration time and isovolumic relaxation time (IVRT) were significantly (P<0.005) higher and E/A velocity ratio was significantly (P<0.05) lower in OW-HT and OB-HT than in L-HT. Prevalence of LVH was significantly higher (P<0.03) in group OB-HT than in L-HT. TGF1 (P<0.004), LVM/h^2.7 (P<0.001) and prevalence of LVH were (P<0.01) significantly higher in hypertensives with diastolic dysfunction than hypertensives with normal diastolic function. TGF1 levels were positively correlated with BMI (r=0.60; P<0.0001), LVM/h^2.7 (r=0.28; P<0.03), IVRT (r=0.30; P<0.02) and negatively with E/A ratio (r=-0.38; P<0.002) in all HT. Multiple regression analysis indicated that TGF1, BMI and IVRT were independently related to E/A ratio explaining 71% of its variability (r=0.84; P<0.0001). This relationship was independent of LVH, age and HR suggesting that TGF1 overproduction may be considered a pathophysiological mechanism in the development of left ventricular filling abnormalities in obesity-associated hypertension.