Echocardiographic assessment of left ventricular mass index and function in hypertensive patients with preserved ejection fraction

Abstract

Background: The aim of the present study is to detect left ventricular (LV) mass and to find out sub clinical LV diastolic dysfunction in hypertensive patients with preserved LV ejection fraction (EF) using echocardiographic parameters.Methods: 96 patients with hypertension were randomly selected irrespective of their sex, race and risk factor and enrolled into this study. Left ventricular mass index (LVMI) and geometrical pattern LV structure were measured. Sub clinical diastolic dysfunction was also assessed by tissue Doppler.Results: Out of 96 patients, 24 had ECG evidence of LV hypertrophy (LVH) 66 were having increased LVMI (154±20), rest 30 had normal LVMI (108±12). They were divided by LV geometrical pattern into concentric LVH (40), eccentric LVH (26), concentric remodeling (19) and normal (11). Diastolic dysfunction in these patients were assessed by E/E´ measurement which was abnormally increased in 42 out of 66 patients with increased LVMI (20±3.4) and 16 out of 30 patients with normal LVMI.Conclusions: Echocardiographic examination help us to find out LVH precisely by calculating LVMI. It also reveals structural changes like concentric LVH, eccentric LVH, concentric remodeling. A significant number of patients with hypertension with normal LV ejection fraction has sub clinical LV diastolic dysfunction which was detected by tissue Doppler imaging (E/E′). The increase in LVMI with or without concentric LVH is an independent risk factor and prognostic marker for cardio vascular events that occur in hypertensive patients. In this study we infer that patients with increase in LVMI with concentric LVH pattern with normal ejection fraction needs more aggressive treatment and regular follow up to prevent cardiovascular complications.