Assessment of Diastolic Function of Heart Failure Patients Due to Systemic Hypertension

Abstract

Introduction: Diastolic function as is the current conventional tradition, in order to gain deeper understanding it is more useful to view diastolic function as a problem to be solved! Once the basic problem of normal physiology of diastole has been mastered, it is nearly self-evident as to what the issues are in clinical heart failure and which physiologic mechanism and its hard-wired compensatory pathways one is confronted with. Objective: To evaluate diastolic function of heart failure patients with systemic hypertension. Methods: The present prospective observational study was undertaken in Cardiology Department, Dhaka Medical College hospital, Dhaka, Bangladesh from January to July, 2019. Fifty-four (54) patients with systemic hypertension who recently experienced heart failure with normal ejection fraction (≥50%) and no clinical history of ischaemic cardiomyopathy were studied. The patients were divided into two groups according to the degree of echocardiographic hypertrophy: Group-I (28 patients) with a ventricular mass/volume ratio >1.8 and group-II (26 patients) with a ratio <1.8. Results: Total 54 patients with diastolic dysfunction with hypertension were included in the study. Shows the age and sex distribution with highest frequency in the age group 61-70 years, comprising 31.5 percent and 51-60 years 25.9 percent, 41-50 year 24.1 percent, 71 + years 12.9 percent and 30-40 years 5.6 percent in descending order. Group I patients had a higher ejection fraction (67.62±3.14 vs 55.33 ±4.13, P<0.001), smaller ventricular diameter (28.88±2.46 vs 34.38±4.37, P<0.001), higher LV mass (154.42±6.80 vs 123.38±5.58, P<0.001), lower ETT positivity (14%vs73%, P<0.001). Clinically, group I had more frequent audible fourth heart sound (57% vs 21%, P< 0.001), low incidence of audible third heart sound (17% vs 69%, P<0.001), ECG evident LVH (96% vs 15%, P<0.001), cardiomegaly (25% vs 73%, P<0.001). Conclusion: There were no significant differences between groups ..........