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A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
Published on: April 30, 2020
The relationship between left ventricular geometric remodeling and cardiac function in essential hypertension
Shigeya Oda1, Minoru Yoshiyama, Naoya Ichiba
1Asakayama General Hospital, Japan.
Insights
Diastolic dysfunction is common in hypertensive heart disease, regardless of left ventricular (LV) geometry. However, the severity of diastolic impairment varies across different LV geometric patterns in these patients.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Abnormal left ventricular (LV) diastolic relaxation is an early indicator of hypertensive heart disease.
- The relationship between diastolic dysfunction and LV geometric patterns in hypertension is not fully understood.
Purpose of the Study:
- To investigate the association between left ventricular (LV) diastolic function and various LV geometric patterns in hypertensive patients.
- To determine if diastolic dysfunction severity differs based on LV geometry.
Main Methods:
- Echocardiography was used to evaluate 220 hypertensive patients.
- Four LV geometric patterns were identified: normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy.
- Diastolic function was assessed using E/A ratio, E wave deceleration time (Dct), and isovolumic relaxation time (IRT).
Main Results:
- All patient groups exhibited prolonged E/A ratio and Dct, indicating diastolic dysfunction.
- Isovolumic relaxation time (IRT) was significantly longer in patients with concentric and eccentric hypertrophy compared to normal geometry and concentric remodeling groups (p < 0.05).
Conclusions:
- Diastolic dysfunction can occur in hypertensive patients irrespective of their left ventricular (LV) geometric pattern.
- The degree of diastolic function impairment is influenced by the specific LV geometric pattern present in hypertensive individuals.
Background:
Abnormal left ventricular (LV) diastolic relaxation is an early sign of hypertensive heart disease. Whether diastolic dysfunction differs between LV geometric patterns remains controversial.
Methods And Results:
We examined 220 hypertensive patients by echocardiography to assess the relationship between diastolic function and LV geometric pattern. We identified four LV geometric patterns: normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy. Diastolic function was evaluated by the E/A ratio, E wave deceleration time (Dct), and isovolumic relaxation time (IRT). The E/A ratio was below one and Dct was prolonged in each group. The duration of IRT in the concentric and eccentric hypertrophy groups was significantly longer than that in normal geometry and concentric remodeling groups (p < 0.05).
Conclusions:
Hypertensive patients may be possible to have diastolic dysfunction, regardless of the differences in their structural geometry. The degree of impairment of cardiac diastolic function differed between hypertensive patients with different LV geometric patterns.
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