ECHOCARDIOGRAPHIC 2D/M-MODE/DOPPLER VELOCITY PARAMETERS OF HYPERTENSIVE CASES VERSUS CONTROLS

Abstract

Introduction: Hypertension is known to cause changes in the LV that impact negatively on the LA both structurally and functionally posing clinically signicant risk to patients. LA size assessment until recently was limited to determination of LA linear diameter and much has not been elucidated with respect to left atrial volume as a surrogate for LA function. It is therefore important to see how LA size (linear diameter and volume) relate to LV function (Systolic and Diastolic) among hypertensive subgroups and normotensive subjects. To compare hypertensive with normotensive using the echocardiographic 2D Objectives: Methods: /M mode/Velocity parameters It is an echocardiographic based descriptive cross-sectional study. A total of 200 hypertensive patients and 100 normotensive controls (matched for age and sex in a 2:1 ratio) were recruited from the cardiology clinics using systematic sampling method. The mean age of the study Results: population was 58.7 ±13.96 (58.42±13.29 for Hypertensives and 59.26±15.27 for Controls) years while the median age was 59years.The female to male ratio was 1.06 among cases and 1.27 among the controls. Majority of the cases had isolated diastolic dysfunction n=149 (74.5%), thirty six (18%) had normal diastolic and systolic functions while 7.5% had combined systolic and diastolic dysfunction (n=15). The LA size (volumes and linear diameter) was signicantly larger in the hypertensive group compared to the control arm. LA reservoir and contractile functions were found to be signicantly higher in the hypertensive cohort while the conduit function was found to be lower among the hypertensive subjects. LA volumes correlated signicantly with E/E'. Among Cases with Isolated LV Diastolic Dysfunction, LV mass correlated signicantly with all measurements of LA size. LA minimum volume correlated signicantly with E/A ratio. Among cases with LV Systolic and Diastolic Dysfunction, LA pre A wave volume correlated signicantly with LV mass. LA volumes correlated better than LA linear diameter with specic parameters of LV diastolic dysfunction among all groups of cases and controls. There was no signicant correlation between age, body mass index versus LA linear diameter and volumes among cases with Normal LV Systolic and Diastolic Function, isolated LV diastolic dysfunction and the group with both LV Systolic and Diastolic Dysfunction. There was signicant association between ECG and Echocardiographic LA enlargement. LA maximum volume correlated signicantly with average systolic blood pressure, pulse pressure and mean arterial pressure. Conclusion: Hypertensive patients have larger LA volumes than normotensive controls. LA volumes correlate better than LA linear diameter with diastolic function variables. It is therefore expedient to use LA volumes routinely in assessing LA size as it may detect early and subtle changes in LA size and function