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[Left ventricular structure and (systolic and diastolic) function in hypertensive patients without atherosclerotic
J R González-Juanatey1, J M García-Acuña, A Amaro Cendón
1Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña.
Insights
Electrocardiogram ST-T changes in hypertensive patients indicate increased left ventricular mass and impaired diastolic function, even without coronary artery disease. A strain pattern specifically suggests worse diastolic function.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Imaging
Background:
- Electrocardiogram (ECG) ST-T abnormalities in hypertension are linked to hypertrophy, ischemia, and cardiovascular risk.
- Assessing left ventricular (LV) structure and function is crucial in hypertensive patients with ECG changes.
Purpose of the Study:
- To evaluate LV structure and systolic/diastolic function in hypertensive patients with normal ECGs versus those with ST-T abnormalities.
- To determine if specific ST-T patterns correlate with distinct echocardiographic findings.
Main Methods:
- Compared 3 groups of hypertensive patients: normal ECG (Control Group), ECG strain pattern (Group A), and other ST-T alterations (Group B).
- Utilized echocardiography and transmitral flow Doppler to assess LV mass, wall thickness, and diastolic function parameters.
- Analyzed parameters including E wave deceleration velocity, deceleration time, A wave deceleration time, and isovolumetric relaxation time.
Main Results:
- Groups A and B showed significantly higher interventricular septum thickness, LV posterior wall thickness, LV mass, and mass index compared to the control group.
- No significant differences in LV systolic function were found across the groups.
- Groups A and B exhibited significant differences in E wave deceleration velocity, deceleration time, A wave deceleration time, and isovolumetric relaxation time compared to controls.
Conclusions:
- ST-T abnormalities in hypertensive patients without coronary artery disease are associated with increased LV mass and impaired diastolic function.
- A specific ST-T strain pattern on ECG is indicative of impaired LV diastolic function.
Introduction And Objectives:
Electrocardiographic (ECG) ST-T segment abnormalities in hypertensive patients are traditionally associated with hypertrophy and/or ischaemia and a higher cardiovascular risk. Hypertensive patients with typical or non-typical chest discomfort and a normal coronarographic study underwent an echocardiographic and Doppler study in order to assess left ventricular structure and (systolic and diastolic) function.
Material And Methods:
Hypertensive patients with ST-T changes were classified as follows: Control group (CG) was made up of 12 hypertensive patients (6 women, 6 men, mean age 59.6 +/- 7.4 years) with normal ECG; Group A (GA), 10 patients (6 women, 4 men, mean age 63.1 +/- 6.8 years) with ECG image of strain; Group B (GB) (9 women and 8 men, mean age 61.3 +/- 10.1 years) with other ST-T alterations. We assessed by echocardiographic and transmitral flow Doppler study left ventricular structure and (systolic and diastolic) function.
Results:
Interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and mass index were significantly higher in the GA and GB than in the CG, without differences between GA and GB groups. No differences in left ventricular systolic function parameters were observed between the groups. In comparison with the CG, the GA and GB showed significant differences in E wave deceleration velocity and deceleration time, A wave deceleration time and isovolumetric relaxation time. Between GA and GB differences were observed in A wave deceleration time and isovolumetric relaxation time.
Conclusions:
In hypertensive patients without atherosclerotic coronaropathy, ST-T changes identify a group with greater left ventricular mass and worse left ventricular diastolic function. The patients with a ST-T strain pattern showed the impaired diastolic function.