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Updated: Feb 26, 2026

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
ECHOCARDIOGRAPHIC CHARACTERISTICS OF DIFFERENT WHO/ISH CARDIOVASCULAR DISEASE RISK GROUPS
E Rukhadze1, N Bregvadze-Tabagari1, L Tvildiani1
1David Tvildiani Medical University, Tbilisi, Georgia.
Insights
Echocardiographic measures of left atrial size and pulmonary systolic pressure show early signs of cardiovascular disease risk, even in individuals without symptoms. These findings suggest incorporating echocardiography into cardiovascular disease risk assessments.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Cardiovascular disease (CVD) risk stratification is crucial for preventive strategies.
- The World Health Organization/International Society of Hypertension (WHO/ISH) risk stratification tool is widely used.
- Early detection of subclinical cardiac changes can improve patient outcomes.
Purpose of the Study:
- To analyze the association between echocardiographic indicators of target organ damage (TOD) and CVD risk groups defined by WHO/ISH.
- To identify early echocardiographic predictors of CVD in a population without clinical symptoms.
Main Methods:
- A cross-sectional study involving 146 participants (66.4% women, 33.6% men) aged [mean age not specified].
- Participants were categorized into three CVD risk groups (WHO/ISH <10%, 10-29.9%, ≥30%).
- Routine echocardiography was performed, and data were analyzed using SPSS version 21.
Main Results:
- Statistically significant differences (P<0.05) were observed in left atrial (LA) size, pulmonary systolic pressure (PSP), and ejection fraction (EF) across WHO/ISH risk groups.
- Moderate LA enlargement and mildly to moderately elevated PSP were noted in the highest risk group (Group 3).
- Ejection fraction showed a tendency towards reduction from lower to higher risk groups, though it remained within normal limits.
Conclusions:
- Left atrial enlargement and elevated pulmonary systolic pressure, even in individuals without overt CVD, may serve as early predictors of cardiovascular disease.
- Echocardiographic assessment should be considered as part of the CVD risk evaluation protocol for selected populations.
Abstract:
The objective of the study was to analyze association of echocardiographic TOD variables with the CVD risk groups defined by WHO/ISH. A cross-sectional study was conducted between (September 2008 - December 2010) Consecutive sample of 146 participants were enrolled in the study, 97 (66.4 %) women and (49) 33,6 % men, mean age. Study population was categorized in three groups according to WHO/ISH risk categories: Group 1 included population with risk less than 10% according to WHO/ISH, in Group 2 there were united two WHO/ISH risk categories (10-10.9% and 20-29.9%) and Group 3 represented population of 30-39.9% and more than 40% of CVD risk. Routine Echocardiography was conducted. The data was analyzed using SPSS, version 21. The distribution of echocardiography characteristics in WHO/ISH groups was statistically different for LA, PSP and EF (P<0.05). In groups I and II LA were only mildly dilated, while in group III was revealed moderate LA enlargement. The mean PSP was in normal range in groups I and II and mildly to moderate elevated in group III. The mean EF was in normal range for all the groups with tendency of reduction from group I to group III. Unlike this we have not found statistically significant differences in other echocardiographic variables, as IVS, PWT, LVD and LVEDV and they were in normal range for all risk groups. According to the findings of our study and considering that our study population is without any clinical presentation of cardiovascular disease and still have statistically significant tendency toward increase in LA and PSP we argue that those variables can be considered as early predictors of cardiovascular disease. Furthermore, it is recommended to include echocardiographic examination as part of the CVD risk evaluation protocol in selected population.
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