6 DIASTOLIC STRESS TESTING ECHOCARDIOGRAPHY (DST) ON PATIENTS WITH HYPERTENSIVE HEART DISEASE WITH POSSIBLY HIGH LEFT VENTRICULAR FILLING PRESSURE IN DR. M. DJAMIL GENERAL HOSPITAL PADANG

Abstract

Background: The prevalence of hypertension tends to increase every year and develops at decades of 3 and 4 of life. Hypertension is a major risk factor of heart failure with a normal left ventricular (LV) ejection fraction (HFpEF). In everyday practice, it is often found complaints of tightness during activity but the results of echocardiography show normal diastolic function or diastolic dysfunction grade I with possibly high left ventricular filling pressure. In 2016, ASE and EACVI issued guidelines for diastolic stress testing (DST) echocardiography to distinguish the cause of shortness of breath whether or not it originated from the heart. The aim of this study to describe the variable hemodynamic responses during diastolic stress echocardiography on patients with hypertensive heart disease. Method: This was a descriptive retrospective study in patient with hypertensive heart disease complaining exertional dyspneu who underwent DST examination from April until November 2018. Resting echocardiography and DST characteristic data were taken from echocardiography laboratories registry and medical records in Dr. M. Djamil General Hospital Padang. Subject were excluded if any of concomitant disease which will affect the LV appeared. Results: Sixty patients underwent diastolic stress echocardiography. Twenty four patients classified as indeterminate and 36 patients were normal diastolic function. Both of this group are on the same age range, around in 50–60 years. Female dominated on this both group. On baseline echocardiography findings of left ventricle structures or functions there were no significant differences. But, on baseline of diastolic LV functions, we found significant differences of lateral e’(p: 0.004), lateral E/e’(p:0,002), and septal E/e’ (p: 0.011). Conclusion: Patients who fall into the indeterminate category, there is still the possibility of high LV filling pressure, so it needs to be proven by invasive strategy. Lower value of lateral e’, lateral E/e’ and septal E/e’ in hypertensive patients have chance of high LV filling pressure.