MYOCARDIAL STIFFNESS IN THE MIDDLE-AGED HYPERTENSIVE PATIENTS IN THE PRESENCE OF OVERWEIGHT OR OBESITY

Abstract

Objective: to evaluate left ventricular (LV) and left atrial (LA) stiffness parameters in middle-aged patients with arterial hypertension grade 1–2 without concomitant cardiovascular diseases in terms of the presence of overweight or obesity. Design and method: Case-control study. We examined 127 naive patients with uncomplicated essential arterial hypertension grade 1–2 and divided them into three groups in accordance with body mass index (BMI) values. The first one is included 19 patients with normal weight - mean BMI 23,2 ± 0,2 kg/m2, mean age 50,6 ± 1,0 years; 7 men; mean office blood pressure 142,1 ± 3,6/ 83,2 ± 2,5 mm Hg). The second group consisted of 52 patients with overweight - mean BMI 28,0 ± 0,2 kg/m2, mean age 53,1 ± 1,0 years; 26 men; mean office blood pressure 147,9 ± 2,0/ 90,9 ± 1,5 mm Hg). And the third group is included 56 patients with obesity - mean BMI 34,2 ± 0,4 kg/m2, mean age 52,0 ± 0,8 years; 33 men; mean office blood pressure 151,7 ± 2,0/ 94,4 ± 1,5 mm Hg). Comprehensive transthoracic echocardiography using Vivid 7 Dimension system (GE) were performed. LV end-diastolic stiffness, LV end-systolic elastance (ESE), LV diastolic elastance, LA stiffness index, LA expansion index and tissue Doppler-derived LA strain were calculated. 2-D speckle tracking echocardiography data were acquired for determination of LV myocardial global longitudinal peak strain (LV GLPS). Results: LV GLPS was significantly (p < 0,001) lower in absolute value in patients with obesity (−15,6 ± 0,4%) compared with overweight group (−18,0 ± 0,4%) and the patients with normal weight (−18,5 ± 0,5%). LV ESE was significantly lower in patients with obesity (3,75 ± 0,13 mm Hg/ml) compared with overweight persons (4,34 ± 0,16 mm Hg/ml; p < 0,05) and the patients with normal weight (4,81 ± 0,26 mm Hg/ml; p < 0,001). No significant differences between studied groups were obtained in other myocardial stiffness parameters. Conclusions: The present study reveals that obesity leads to increased LV myocardial stiffness in untreated middle-aged patients with uncomplicated arterial hypertension grade 1–2 in comparison with sex-, age- and hypertension history-matched patients with overweight or normal BMI.