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Left ventricular hypertrophy and diastolic function in children and adolescents with essential hypertension

Heirim Lee1, Young-Hwa Kong1, Kyung-Hee Kim1

  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710 South Korea.

Clinical Hypertension
|February 20, 2016
PubMed

Insights

Left ventricular hypertrophy is common in hypertensive children and adolescents, correlating with BMI but not directly with blood pressure metrics. Diastolic dysfunction risk increases with left ventricular hypertrophy in this population.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Essential hypertension in pediatric populations is often associated with underdiagnosed cardiac changes.
  • Left ventricular hypertrophy and diastolic dysfunction are key indicators of cardiovascular risk in adolescents.

Purpose of the Study:

  • To investigate the prevalence and characteristics of left ventricular hypertrophy and diastolic dysfunction in children and adolescents with essential hypertension.
  • To determine the relationship between ambulatory blood pressure monitoring (ABPM) parameters and cardiac remodeling.

Main Methods:

  • A cohort of 38 Korean pediatric patients (9-19 years) with essential hypertension diagnosed via ABPM were analyzed.
  • Echocardiography, including tissue Doppler imaging, was used to assess left ventricular mass index (LVMI) and diastolic function (E/A, E/E').
  • Patients were stratified into elevated and normal blood pressure index groups based on ABPM.

Main Results:

  • Elevated blood pressure index was associated with significantly higher LVMI, but not with impaired diastolic function (E/A, E/E' ratios).
  • LVMI was primarily correlated with body mass index (BMI), independent of ABPM parameters.
  • Subjects with left ventricular hypertrophy showed higher E/E' ratios, suggesting potential diastolic dysfunction.

Conclusions:

  • Left ventricular mass index is significantly correlated with BMI in pediatric essential hypertension.
  • Children and adolescents with left ventricular hypertrophy may be at a higher risk for diastolic dysfunction.
Abstract

Keywords:
Ambulatory blood pressure monitoringDiastolic dysfunctionLeft ventricular hypertrophyPediatric essential hypertension

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