PREVALENCE OF DIFFERENT LEFT VENTRICULAR REMODELING PATTERNS IN HYPERTENSIVE PATIENTS ACCORDING TO NEW ASE CRITERIA: PP.35.470

Abstract

Objective: The study addresses the impact of different criteria of left ventricular hypertrophy (LVH) and concentric remodelling to prevalence of remodelling patterns in hypertension. The ASE 2005 recommendations significantly reduced the threshold for LVH detection and relative wall thickness (RWT) threshold for concentric geometry pattern. Design and Methods: We examined 734 patients with essential hypertension 9EH) who had no concomitant diseases and medication. Echocardiography was performed and analyzed by one observer. The left ventricular mass index (LVMI) and RWT were calculated. The remodelling patterns were assesses by classification of Ganau et al 1991and new ASE criteria (2005). The concentric (CLVH) and eccentric (ELVH) LVH were diagnosed as well as normal Geometry (NG) and Concentric remodelling (CR). Results: According to Ganau et al (1991) criteria the prevalence of CLVH was 237 (32,3%), E LVH - 231 (31,5%), concentric remodelling - 49 (6,7%) and 217 (29,5%) patients had normal geometry. When recalculated by ASE 2005 criteria it became 380 (51,8%), 175 (23,8%), 50 (6,8%), and 129 (17,6%) respectively. Thus, implementation of new ASE criteria for LV remodelling in hypertension significantly increases the proportion of patients with CLVH, whoa are considered to be at higher risk of complications. This was explained by both criteria changes – decreased threshold for LVH and 25 patients and changing of threshold for RWT from 0,45 to 0,42 (117 cases). Conclusions: The introduction of new criteria for LVH with lower threshold and changes of RWT threshold significantly increases the proportion of patients with high risk, who need more aggressive antihypertensive treatment and thus significantly contributes to hypertension management including economic consequences.