Left ventricular diastolic function in hypertensive patients with different geometric patterns of left ventricle

Abstract

Objective The aim of this study was to evaluate diastolic function of left ventricle in hypertensive patients with different geometric patterns of left ventricle. Design and method The study included 88 hypertensive patients (mean age 52±8 years) and 45 healthy persons (mean age 51±7 years). The endsystolic and enddiastolic left ventricle dimensions, thickness of interventricular septum (IVS) and left ventricle posterior wall (PWT) were measured in all subjects by using two-dimensional echocardiography. The ratio of early and late diastolic transmitral flow velocities (E/A) was assessed by Doppler echocardiography and the ratio of early diastolic mitral flow velocity was achieved by pulsed-wave Doppler and tissue Doppler (E/Ea) in all subjects. Left ventricle mass index (LVMI) was calculated for all subjects. According to the value of relative wall thickness (RWT) and LVMI hypertensive patients were subdivided into four groups: normal (N) 30 (34%), concentric remodeling (CR) 28 (31.8%), concentric hypertrophy (CH) 20 (22.7%) and eccentric hypertrophy (EH) 10 (11.4%) patients. Results The E/A ratio gradually decreased in hypertensive patients from N to EH group (N, 1.1±0.13; CR, 1.01±0.14; CH, 0.88±0.15; EH, 0.85±0.14), and it was lower comparing it with control group (1.24±0.19), (p<0.01 for all). The E/Ea ratio was higher in all hypertensive groups (N, 9.43±1.72; CR, 10.09±2.86; CH, 14.85±3.76; EH, 11.66±3.03) compared with the controls (6.58±1.12), (p<0.01 for all). In CH group the E/Ea ratio was higher than in N, CR and EH groups (p<0.01, p<0.01, p=0.02, respectively). The E/Ea ratio in hypertensive group was correlated with LVMI (r=0.29, p<0.01), RWT (r=0.21, p=0.032) and IVS (r=0.31, p<0.01). Conclusion Left ventricular diastolic function is impaired in all hypertensive patients. The degree of geometric pattern diastolic cardiac function damage is the most obvious in concentric hypertrophy left ventricle geometric pattern. Objective The aim of this study was to evaluate diastolic function of left ventricle in hypertensive patients with different geometric patterns of left ventricle. Design and method The study included 88 hypertensive patients (mean age 52±8 years) and 45 healthy persons (mean age 51±7 years). The endsystolic and enddiastolic left ventricle dimensions, thickness of interventricular septum (IVS) and left ventricle posterior wall (PWT) were measured in all subjects by using two-dimensional echocardiography. The ratio of early and late diastolic transmitral flow velocities (E/A) was assessed by Doppler echocardiography and the ratio of early diastolic mitral flow velocity was achieved by pulsed-wave Doppler and tissue Doppler (E/Ea) in all subjects. Left ventricle mass index (LVMI) was calculated for all subjects. According to the value of relative wall thickness (RWT) and LVMI hypertensive patients were subdivided into four groups: normal (N) 30 (34%), concentric remodeling (CR) 28 (31.8%), concentric hypertrophy (CH) 20 (22.7%) and eccentric hypertrophy (EH) 10 (11.4%) patients. Results The E/A ratio gradually decreased in hypertensive patients from N to EH group (N, 1.1±0.13; CR, 1.01±0.14; CH, 0.88±0.15; EH, 0.85±0.14), and it was lower comparing it with control group (1.24±0.19), (p<0.01 for all). The E/Ea ratio was higher in all hypertensive groups (N, 9.43±1.72; CR, 10.09±2.86; CH, 14.85±3.76; EH, 11.66±3.03) compared with the controls (6.58±1.12), (p<0.01 for all). In CH group the E/Ea ratio was higher than in N, CR and EH groups (p<0.01, p<0.01, p=0.02, respectively). The E/Ea ratio in hypertensive group was correlated with LVMI (r=0.29, p<0.01), RWT (r=0.21, p=0.032) and IVS (r=0.31, p<0.01). Conclusion Left ventricular diastolic function is impaired in all hypertensive patients. The degree of geometric pattern diastolic cardiac function damage is the most obvious in concentric hypertrophy left ventricle geometric pattern.