Left ventricular hypertrophy. Relation of structure to diastolic function in hypertension

Area of Science:

• Cardiology
• Physiology

Background:

• Systemic hypertension is a common condition associated with left ventricular hypertrophy.
• Diastolic dysfunction can occur in hypertensive heart disease, but its relationship with hypertrophy requires further elucidation.

Purpose of the Study:

• To investigate the relationship between the degree of left ventricular hypertrophy and abnormalities in isovolumic relaxation and diastolic function in hypertensive patients.
• To compare diastolic function in hypertensive patients with left ventricular hypertrophy to that in athletes with similar hypertrophy and healthy controls.

Main Methods:

• Digitized M-mode echocardiography was employed to assess left ventricular mass, cavity dimensions, and diastolic function parameters.
• Study groups included 56 hypertensive patients (varying severity), 10 athletes with hypertrophy, and 20 healthy subjects.

Main Results:

• Hypertensive patients and athletes showed increased left ventricular mass; athletes had increased cavity dimensions, while hypertensive patients had normal dimensions.
• All hypertensive patients exhibited prolonged isovolumic relaxation, delayed mitral valve opening, and impaired early diastolic filling, irrespective of hypertrophy severity.
• Athletes with comparable hypertrophy to hypertensive patients demonstrated entirely normal diastolic function.
• Measurements of diastolic function were significantly correlated with left ventricular wall thickness and mass in hypertensive individuals.

Conclusions:

• In hypertensive patients with non-dilated left ventricular hypertrophy, increased wall thickness is directly related to impaired diastolic function and prolonged isovolumic relaxation.
• Hypertrophy in athletes does not lead to diastolic dysfunction, suggesting that hypertension itself contributes significantly to these functional abnormalities.