Left ventricular systolic and diastolic function and geometric patterns in elderly hypertensives

Abstract

Systolic and diastolic dysfunction are quite common among elderly hypertensive patients (pts), but their prevalence respect to different hypertensive left ventricular (LV) geometric patterns is still matter of debate. Aim of the present study was to evaluate LV function respect to the presence of LV hypertrophy (H) and to the different LV geometric patterns in elderly pts with high blood pressure. We studied 134 hypertensive pts more than 65 years aged (M 83, F 51, mean age 70.8 years, range 65–82); they were submitted to clinical and echocardiographic evaluation, assessing blood pressure values, LV diastolic and systolic dimensions, LV mass, LV mass index (LV mass/height2.7), systolic function (ejection fraction, midwall fractional shortening), diastolic function (mitral E/A rate, E wave deceleration time, isovolumetric relaxation time). LVH was defined by a mass index > 51 g/m 2.7; concentric pattern was defined by a relative wall thickness [RWT = (diastolic LV posterior wall thickness + diastolic interventricular septum thickness)/LV diastolic diameter] > 0.45. So normal pattern had normal LV mass and RWT, concentric remodelling normal LV mass and high RWT, eccentric H high LV mass and normal RWT, and concentric H high LV mass and RWT. The results are represented in the table LV systolic and diastolic function by geometric pattern BP = blood pressure, EF = ejection fraction, MFS = midwall fractional shortening, EDT = E wave deceleration time, IVRT = isovolumetric relaxation time LV systolic and diastolic function by geometric pattern BP = blood pressure, EF = ejection fraction, MFS = midwall fractional shortening, EDT = E wave deceleration time, IVRT = isovolumetric relaxation time No significant difference in LV dysfunction was observed among different geometric patterns, even whether a trend was observed towards a worse E/A in concentric H (analysis of variance p<0.05), which can contribute to explain the known worse prognosis of this kind of LVH.