Aortic regurgitation and aortic root systolic excursion in patients with severe arterial hypertension in Sub-Saharan Africa: A cross sectional echocardiographic study

Abstract

Arterial hypertension is one of the main cardiovascular risk factors. Hypertensive heart disease refers to heart conditions caused by high blood pressure. Aortic regurgitation and Aortic Root Systolic Excursion (ARSE), which are parameters altered early in the course of the disease can be used to rapidly evaluate the heart function of patients presenting with severe hypertension. To describe patients presenting with severe hypertension, and to find the prevalence of aortic regurgitation, and of an abnormal ARSE. This was a cross sectional study including patients with severe hypertension attending cardiology outpatient consultation in two tertiary hospitals of Yaoundé, Cameroon. Clinical data were recorded and echocardiography were done by two experienced cardiologists to evaluate cardiac function. Ninety-two patients were recruited. The mean age was 60.8 ± 13.1 (23–96) years. The median blood pressure values were 189 (IQR 180–207) for systolic and 114 (103–123) for diastolic. The main antihypertensive medication class used were calcium channel blockers. In this sample 16(17.4%; 95% CI: 9.8–25) patients had aortic regurgitation, 6(6.5%; 95% CI: 2.2–12) patients had an abnormal ARSE and 16(17.4%; 95% CI: 9.8–25) patients had a left ventricular systolic dysfunction given by a left ventricular ejection fraction <50% calculated using biplane Simpson's method respectively 6.5% (95% CI: 2.2–12), 17.4% (95% CI: 9.8–25) and 17.4% (95% CI: 9.8–25). A low prevalence of aortic regurgitation and ARSE were found in this sample of patients with severe hypertension. These results suggest that aortic regurgitation and an abnormal ARSE are probably linked more to the duration that to the severity of hypertension.