Abstract
Hypertensive cardiomyopathy with reduced ejection fraction (HTCMREF) is known as an important cause of reversible cardiomyopathy, but its serial changes on echocardiography is yet to be elucidated. HTCMREF on serial echocardiography has distinctive points as compared to idiopathic dilated cardiomyopathy (idDCM). We retrospectively studied 18 hypertensive patients (mean age, 63 ± 13 years, 56% women) admitted with severe left ventricular (LV) systolic dysfunction and heart failure. We compared clinical characteristics and echocardiographic parameters at admission and follow-up between the patients with HTCMREF and 18 age-matched patients with idDCM. Left ventricular mass (LVM) and left atrial volume (LAV) were calculated by a formula using echocardiographic measurement. In HTCMREF, left ventricular ejection fraction improved to 52.3 ± 8.8% during a mean follow-up of 574 days. In HTCMREF, initial left atrial diameter was greater than in idDCM (43.6 ± 5.8 mm vs 38.9 ± 6.3, p = 0.027). At follow-up, LAV index decreased in HTCMREF (from 31.9 ± 8.3 mL/m(2) to 21.0 ± 8.9, P < 0.001), as opposed to a significant increase in idDCM (from 28.5 ± 10.9 mL/m(2) to 31.9 ± 8.3, P < 0.001). There was no significant difference in initial LVM index between the 2 groups, but only in HTCMREF did LVM index decrease significantly (151.4 ± 42.1 g/m(2) from 192.2 ± 43.7, P < 0.01) at follow-up. In HTCMREF, LV wall on M-mode was thicker than in idDCM. Hypertensive cardiomyopathy with severe LV systolic dysfunction might be characterized by eccentric left ventricular hypertrophy and enlarged left atrium in comparison with idDCM.
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