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[Echocardiographic parameters and systolic times in arterial hypertension in the elderly]
Insights
Systolic-diastolic hypertension in older adults is linked to increased left ventricular dimensions and mass, and reduced ejection fraction. Systolic hypertension shows distinct changes, impacting cardiac structure and function differently.
Area of Science:
- Cardiology
- Gerontology
- Medical Imaging
Context:
- Hypertension is a prevalent condition in aging populations, often leading to cardiac structural and functional changes.
- Understanding the specific echocardiographic manifestations of different hypertension types in the elderly is crucial for risk stratification and management.
- M-mode 2D echocardiography and echophonocardiography are established tools for assessing cardiac structure and function.
Purpose:
- To investigate and compare echocardiographic parameters in elderly individuals with systolic-diastolic hypertension, systolic hypertension, and normotensive controls.
- To identify specific cardiac alterations associated with different hypertensive profiles in the aged population.
- To evaluate left ventricular dimensions, wall thickness, ejection fraction, and systolic time intervals in relation to hypertensive status.
Summary:
- Systolic-diastolic hypertension was associated with increased left ventricular end-diastolic diameter (EDD), posterior wall thickness (SPPD), and left ventricular mass (LVM), along with a reduced ejection fraction (EF) and increased PEP/LVET ratio compared to controls.
- Systolic hypertension did not elevate EDD but showed increased septal thickness (SSD) and PEP/LVET ratio, with EF remaining within normal limits.
- Healthy aged subjects exhibited normal SSD, SPPD, and LVM.
Impact:
- This study highlights distinct echocardiographic signatures for different types of hypertension in the elderly, aiding in more precise diagnosis and targeted therapeutic strategies.
- Findings underscore the importance of comprehensive echocardiographic assessment in hypertensive older adults to detect subclinical cardiac remodeling and dysfunction.
- The results contribute to a better understanding of age-related cardiovascular changes and the specific impact of hypertension on cardiac mechanics.
Abstract:
In 40 subjects, 15 mean age 70.7 +/- 5.6 with systolic-diastolic hypertension, 15 mean age 75.5 +/- 6.8 years with systolic hypertension and 10 mean age 73.6 +/- 5.1 normotensive control group we have analyzed with M-mode 2D echocardiography and echophonocardiography the following parameters: diastolic--EDD--and systolic diameter--SD--of left ventricle, diastolic thickness of septum--SSD--and posterior wall--SPPD--of left ventricle, left ventricular ejection fraction--EF--(Theicholtr. formula), radius posterior wall thickness--R/SPPD--, left ventricular mass--LVM--(Devereux' formula), and systolic time intervals (Q-A2, LVET, PEP and PEP/LVET). The differences between groups are: systolic-diastolic hypertensive patients have increased EDD, SPPD and LVM, reduction of EF and increased PEP/LVET ratio in comparison with B and C groups; systolic hypertension doesn't increase EDD; SSD and PEP/LVET increase, while the EF remains within normal limits. In the healthy aged subjects SSD, SPPD and LVM are normal.