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Echocardiographic and Doppler evaluation of left ventricular hypertrophy and diastolic function in black and white
D Rittoo1, M Monaghan, T Sadiq
1Cardiac Department, King's College Hospital, London, UK.
Insights
Black and white patients with left ventricular hypertrophy showed impaired diastolic function, independent of blood pressure or hypertrophy severity. Echocardiography revealed abnormal diastolic function in both groups.
Area of Science:
- Cardiology
- Physiology
- Medical Imaging
Background:
- Left ventricular hypertrophy (LVH) is a common cardiovascular condition.
- Diastolic dysfunction can occur independently of systolic dysfunction in LVH.
- Racial differences in cardiovascular disease prevalence warrant investigation.
Purpose of the Study:
- To compare left ventricular hypertrophy and diastolic function between black and white patients.
- To investigate the relationship between blood pressure, LVH, and diastolic function.
Main Methods:
- Echocardiography with Doppler examination was performed on 24 matched patients (12 black, 12 white).
- Left ventricular mass, wall thickness, and diastolic function indices (peak E and A velocities, E/A ratio) were assessed.
- Patients were matched for age, heart rate, and blood pressure.
Main Results:
- Both black and white patients exhibited significant left ventricular hypertrophy with normal systolic function but impaired diastolic function.
- Left ventricular mass and posterior wall thickness correlated with systolic blood pressure in all patients.
- In black patients, blood pressure correlated with LV mass and wall thickness.
- Diastolic function indices did not correlate with blood pressure or LVH severity.
- No morphological differences in the left ventricle were observed between racial groups.
Conclusions:
- Significant left ventricular hypertrophy and impaired diastolic function are present in both black and white patients, irrespective of blood pressure or hypertrophy degree.
- The observed diastolic dysfunction appears independent of blood pressure and LVH severity.
- A neurohumoral mechanism may contribute to the observed diastolic dysfunction.
Abstract:
Echocardiography including Doppler examination has been used to assess left ventricular hypertrophy and diastolic function in 24 patients: 12 black Negro patients and 12 white patients who were matched with respect to age, heart rate and systolic and diastolic blood pressure. Significant left ventricular hypertrophy was present with normal systolic function but impaired diastolic function with a decrease in peak E velocity, an increase in peak A velocity and reversal of the E/A ratio. In the combined groups LV mass and LVPW correlated with systolic blood pressure (P less than 0.05). In the blacks systolic and diastolic blood pressure correlated with LV mass and LVPW thickness (P less than 0.05). Septal thickness correlated only with systolic blood pressure (P less than 0.01). In contrast the indices of diastolic function did not correlate with blood pressure or with left ventricular hypertrophy. No morphological differences in the left ventricle have been shown between the two groups but both had significant left ventricular hypertrophy. Whilst diastolic function is abnormal, this appeared to be independent of either blood pressure or degree of left ventricular hypertrophy. A neurohumeral mechanism has not been discounted.