Related Experiment Videos
Left ventricular cardiac structure and diastolic function in isolated systolic hypertension in the elderly
T Sumimoto1, E Murakami, T Iwata
1Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
Insights
Isolated systolic hypertension (ISH) in the elderly is linked to left ventricular concentric hypertrophy and impaired diastolic function. This study highlights significant cardiac structural changes and reduced relaxation in older adults with ISH.
Area of Science:
- Cardiology
- Geriatrics
- Hypertension Research
Background:
- Elderly individuals with isolated systolic hypertension (ISH) present unique cardiovascular challenges.
- Understanding the impact of ISH on cardiac structure and diastolic function is crucial for geriatric cardiovascular health.
Purpose of the Study:
- To investigate left ventricular cardiac structure and diastolic function in elderly patients with ISH.
- To compare these parameters with age-matched patients with essential hypertension (EHT) and normotensive controls (NT).
Main Methods:
- M-mode echocardiography was used to measure left ventricular end-diastolic dimension (LVDd), end-systolic dimensions (LVDs), left ventricular mass index (LVMi), and isovolumic relaxation time (IRT).
- Patients were categorized into ISH, EHT (further divided by mean wall thickness), and NT groups.
Main Results:
- Patients with ISH exhibited significantly smaller LVDd compared to NT, EHT-I, and EHT-II groups.
- ISH was associated with the greatest relative wall thickness due to decreased chamber size and increased left ventricular wall thickness.
- Left ventricular isovolumic relaxation time was significantly longer in ISH patients than in the EHT-I group, indicating impaired diastolic function.
Conclusions:
- Elderly patients with ISH demonstrate left ventricular concentric hypertrophy.
- A severely impaired diastolic function is a key characteristic of ISH in the elderly population.
Abstract:
We examined the left ventricular cardiac structure and the diastolic function in patients with isolated systolic hypertension (ISH; SBP > or = 160 mmHg and DBP < 90 mmHg) in the elderly. We studied 17 patients with ISH, 24 age-matched patients with essential hypertension (EHT; DBP > or = 90 mmHg) and 17 normotensive controls (NT; SBP < 140 mmHg and DBP < 90 mmHg). EHT were divided into two groups based on the mean wall thickness (MWT) of the left ventricle. Group 1 patients (EHT-I, n = 12) had a MWT < 10 mm and group 2 patients (EHT-II, n = 12) had a MWT > or = 10 mm. We measured left ventricular end-diastolic dimension (LVDd), end-systolic dimensions (LVDs), left ventricular mass index (LVMi) and left ventricular isovolumic relaxation time (IRT) to assess the left ventricular cardiac structure and the diastolic function by M-mode echocardiography. LVDd was significantly smaller in ISH than in NT, EHT-I and EHT-II (P < 0.01). Relative wall thickness was greatest in ISH because of both the decreased chamber size and the increased left ventricular wall thickness. LVMi in ISH was similar to that in EHT-I, but IRT in ISH was significantly longer than that in EHT-I (P < 0.05). These results suggest that ISH in the elderly shows a left ventricular concentric hypertrophy and a severely impaired diastolic function.