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[Influence of left ventricular hypertrophy on its function in essential arterial hypertension. Analysis by Doppler
T Vicente Vera1, C Díaz de la Vega, F Gabbai
1Instituto Nacional de Cardiología Ignacio Chávez, Tlalpan, México, D.F.
Insights
Left ventricular hypertrophy (LVH) in essential arterial hypertension (EAH) patients impairs left ventricular function, reducing stroke volume and fractional shortening. Increased left ventricular mass correlates with decreased diastolic diameter and stroke volume.
Area of Science:
- Cardiology
- Physiology
Context:
- Essential arterial hypertension (EAH) is a common condition.
- Left ventricular hypertrophy (LVH) is a frequent complication of EAH.
- The functional impact of LVH on left ventricular performance requires further elucidation.
Purpose:
- To investigate the influence of left ventricular hypertrophy (LVH) on left ventricular function in patients with essential arterial hypertension (EAH).
Summary:
- Doppler echocardiography was used to study 20 EAH patients without coronary artery disease or kidney involvement.
- Left ventricular mass (LVM) showed an inverse relationship with fractional shortening, mean velocity of circumferential shortening (Vcfr), end-diastolic diameter, and stroke volume.
- The E/A ratio was proportional to fractional shortening and Vcfr, while A velocity was inversely proportional to Vcfr.
Impact:
- Findings suggest that LVH in EAH patients is associated with impaired systolic and diastolic function.
- This study highlights the detrimental effects of LVH on overall left ventricular performance.
- Understanding these functional changes is crucial for managing hypertensive heart disease.
Abstract:
In order to evaluate the influence of left ventricular hypertrophy (LVH) on the function of this ventricle, twenty patients with essential arterial hypertension (EAH) were studied using Doppler echocardiography. Patients with diastolic blood pressure greater than 91 mmHg were included. Antihypertensive treatment was stopped 2 weeks before the study. None of them had any concomitant coronary artery disease nor kidney involvement. Left ventricular diameters, left ventricular mass (LVM), stroke volume, fractional shortening, mean velocity of circumferential shortening (Vcfr), mean velocity of circumferential relaxation, mean velocity of aortic flow and mean E and A velocities of mitral flow as well as the ratio of these velocities (E/A) were measured or calculated. With those values from the entire group, arithmetic means were calculated and the population was divided into two groups: those with values greater than the mean and those with values below the mean for each variable for comparative purposes. The relationship of the individual values was also calculated. The interventricular septum thickness and the left ventricular end diastolic diameter were proportional with diastolic blood pressure (p less than 0.05). The LVM values shown an inverse relationship to the fractional shortening (p less than 0.01), Vcfr (p less than 0.05) as well as end diastolic diameter of left ventricle (r = -0.889, p less than 0.01) and with the stroke volume (r = -0.861, p less than 0.01). The E/A ratio was proportional to the fractional shortening (p less than 0.05) and to Vcfr (r = 0.903). The A velocity of the mitral Doppler flow showed an inverse proportion to the Vcfr (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)