Abstract
Precedents: In pathological left ventricular (LV) hypertrophy (H) of hypertensive patients (P) there is a deposition of collagen. Myocardial fibrosis is one of the factors responsible for systolic and diastolic dysfunction. Athletes increase their ventricular mass as physiological ventricular H. Integrated backscatter (IB) demonstrates changes in myocardial acoustic properties, depending upon their composition and function. Objectives: (1).Assess the capability of IB to differentiate physiological from pathological H. (2).Correlate IB with overall and regional systolic and diastolic functions. Methods: Group I(GI):13 hypertensive P with an LV mass index (LVMI)>124 gr/m2, Group II(G2):11 athletes, Group III(G3): 8 volunteers. We determined overall systolic and diastolic functions and regional function of the basal septum, IB and cyclic variation of the IB (CVIB) of the posterior wall. Results: Age (years): G1:52 ± 15, G2:28 ± 8 G3:35 ± 8 p = 0.000; Sex: G1:m/f 12/1, G2: m/f 9/2, G3: m/f 4/4, LVMI: G1: 180.1 ± 58 gr/m2, G2:130.2 ± 20 gr/m2 G3: 90.2 ± 16 gr/m2 p = 0.000. Left atrial area (LAA): G1: 22 ± 4 cm2, G2: 18.8 ± 1.8 cm2, G3: 15.8 cm2 p = 0.001, mid‐wall shortening fraction (MWSF): G1:26.9 ± 3.5, G2:27.5 ± 4 G3:25 ± 3 p = NS; CVIB: G1:5,3 ± 2,5 G2:7.6 ± 2,1 G3:6.4 ± 1.1 P = 0.048.Correlation of IB and MWSF, p = NS; IB and MWSF p = NS, IB and CVIB:‐0.56 p = 0.005. Group 1 Goup 2 Group 3 P Correlation IB P Regional S 4.83 ± 0.9 5.68 ± 0.8 5.65 ± 1.3 0.03 regional −0.49 (p = cm/seg S 0.015) Regional e/a 0.8 ± 0.3 2.1 ± 0.6 1.9 ± 1.3 0.002 e/a −0.43 (p = 0.038) Transmitral 1.2 ± 0.3 2 ± 0.75 1.9 ± 0.9 0.008 E/A NS E/A BI (dB) 41 ± 6 29 ± 6 35 ± 8 0.001 LAA 0.43 (p = 0.037) Conclusion: (1). An increase in IB was seen in hypertensive patients, which may be the echocardiographic manifestation of myocardial fibrosis and/or depressed ventricular function. (2). IB differentiates physiological from pathological H. (3). Regional systolic and diastolic functions correlate inversely with IB in hypertensive patients, whereas LAA correlates with IB.
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