Abstract
Background: Coronary artery disease (CAD) was known to cause an increase in left ventricular mass and changes in cardiac dimensions in hypertensive patients. There is a novel classification of left ventricular (LV) geometry. Objective: To evaluate the impact of CAD on LV geometry (LV dilatation, hypertrophy, and concetricity) in hypertensive patients at the Hasan Sadikin General Hospital Bandung. Method: Between September and December 2019, 115 consecutive patients underwent trans-thoracal echocardiography examination in Hasan Sadikin General Hospital Bandung, who had suffered from hypertension. Hypertension was defined as resting systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg or on antihypertensive therapy routinely. CAD was defined as the patients have a known history of CAD in the medical record. Patients were divided based on LV dilation (end-diastolic volume[EDV]/body surface area[BSA]>75 ml/m2), LV hypertrophy (LVM/BSA>115 and >95 g/m2 on men and women respectively), and concentricity (RWT>0.42;0.32–0.42;or<0.32). Results: One-hundred-ten patients were included after excluding patients with incomplete data. Sixty patients (54.55%) were females, mean age was 56.95±11.54 years old. Forty patients was diagnosed CAD (36.36%), 70 patients non-CAD (63.63%). Dilation LV was found in 23 patients (20.9%); CAD vs non-CAD (15/40 (37,5%) vs 8/70 (11,8%)); p = 0,001. Hypertrophic LV was found in 70 patients (63.6%); CAD vs non-CAD (32/40 (80%) vs 38/70 (54.3%)); p = 0,008. Concentricity RWT > 0,42 (60%), RWT 0,32–0,42 (31.8%), RWT < 0,32 (8.2%). In CAD vs non-CAD (26/7/7 vs 40/28/2); p = 0,04. Conclusion: In hypertensive patients, CAD group has significant difference in LV dilatation, hypertrophy, and concentricity compared to it counterparts. Based on this novel classification, CAD in hypertensive patients might have an impact on its prognosis.
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