NON-INVASIVE MYOCARDIAL FIBROSIS EVALUATION IN YOUNG HYPERTENSIVE MEN: PP.22.369

Abstract

Objective: The development of myocardial fibrosis is an important determinant of pathological stiffness of myocardium in arterial hypertension (AH), resulting in left ventricle (LV) diastolic dysfunction. Due to obvious reasons the use of “golden standard” - endomyocardial biopsy - for the early diagnosis of myocardial fibrosis is limited. Pixel frequency distribution of signals from graphic analysis of LV wall has been shown to correlate with morphological and serological markers of myocardial fibrosis. The aim of the study was evaluation of echocardiograhic signs of myocardial fibrosis in young hypertensive men Methods: Echocardiography (VIVID 7, GE) was performed in three groups of men of 18–25 years old (average age 20,9 ± 2,0 years): 74 with sustained AH, 45 with non-sustained AH, and 26 normotensive subjects. The groups were matched on age, height and weight. Blood pressure (BP) status was assessed with repeated clinic measurement and ambulatory BP monitoring. The parasternal long axis images of LV were recorded in diastole and evaluated with NIH image software by deducing minimal from the maximal pixel frequency distribution of signals to find the broad band (BB) in mid-interventricular septum. Results: In subjects with sustained AH LV mass was 201,2 ± 18,0 g, LVMI 97,6 ± 17,1 g/m2, BB 182,2 ± 17,9. In subjects with non-sustained AH the values were 172,2 ± 35,1 g, 85,1 ± 15,2 g/m2 and 159,7 ± 22,7, respectively. In normotensive men 152,0 ± 17,0 g, 73,7 ± 8,5 g/m2, 142,4 ± 19,6. The differences between the values in sustained AH and normotensive group were significant (p < 0,01). Conclusion: In young men AH is associated with increased LVMI and increased pixel frequency distribution of signals, which potentially may indicate the presence of myocardial fibrosis as early sing of LV remodelling.