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[Echocardiographic evaluation of left ventricular function in patients with arterial hypertension and normal left
1Institut za kardiovaskularne bolesti, Sremska Kamenica, Institutski put 4.
Insights
Hypertension can cause subtle left ventricular (LV) changes before significant enlargement occurs. Diastolic dysfunction in hypertensive patients often precedes myocardial hypertrophy, indicating early cardiac alterations.
Area of Science:
- Cardiology
- Hypertension Research
- Diastolic Function
Background:
- Diastolic dysfunction of the left ventricle (LV) is documented in hypertension.
- These changes can occur before evident myocardial hypertrophy or increased LV mass index.
Purpose of the Study:
- To investigate diastolic function disturbances in hypertensive patients with a normal LV mass index.
- To confirm if early microstructural changes precede LV hypertrophy in hypertension.
Main Methods:
- Examined 144 patients (114 hypertensive, 30 controls).
- Measured blood pressure, heart rate, LV dimensions, mass index, wall stress, volumes, cardiac output, ejection fraction, shortening fraction.
- Assessed diastolic filling parameters including peak early/late filling velocities and their relationship, and early/late filling indices.
Main Results:
- Significant differences observed in LV mass index, wall stress, peak early diastolic filling velocity, and the ratio of early to late diastolic filling velocities.
- While parameters remained within normal ranges, hypertensive patients showed values closer to pathological limits.
Conclusions:
- Microstructural changes in LV myocardium can be detected in hypertensive patients prior to a significant increase in LV mass index.
- Left ventricular diastolic dysfunction precedes myocardial hypertrophy in the context of hypertension.
Unlabelled:
Data about disturbances of the diastolic function of the left ventricle (LV) are well known in literature and registered even in the limited form of hypertension i.e. before the occurrence of myocardial hypertrophy. The aim of this work was to check this hypothesis in patients with arterial hypertension and normal LV mass index. The total number of examined patients was 144. The control group consisted of 30 patients, while the number of hypertensive patients in the other group was 114. The following parameters were observed: blood pressure, heart rate, systolic and diastolic dimensions of LV, wall thickness, left ventricular mass index, wall stress, endsystolic and enddiastolic volume index, cardiac index, ejection fraction, shortening fraction, velocity peak of early and late diastolic filling and their mutual relationship, integral of speed-time of early and late diastolic pressure, as well as the index of early and late filling. A significant difference was found in the size of LV mass index, wall stress, velocity peak of early diastolic filling and the relationship of velocity peak of early and late filling. It should be noted that the values of the observed parameters were in normal ranges, but those in the group of hypertensive patients were closer to pathological values.
Conclusion:
Microstructural changes of LV myocard mass can be registered in hypertensive patients before the significant enlargement of LV mass index. Diastolic disfunction of the left ventricle precedes myocardial hypertrophy.