The Effect of Left Ventricular Geometry on Myocardial Performance Index in Hypertensive Patients
Mohammed Yasser Allam;
Abstract
According to the world health organization (WHO), hypertension is the most common cardiovascular disorder in the world. In Egypt, the prevalence of hypertension was 26.3% according to Egyptian National Hypertension Project (NHP).
Hypertension is associated with high prevalence of abnormalities of the left ventricular performance and structure including LVH, LV diastolic and systolic dysfunction.
Initially, LVH is regarded as adaptive process; once the critical mass is exceeded, it becomes a disease. According to LVMI and RWT, there are four types of left ventricular geometric patterns:
• Concentric Hypertrophy (CH): (Increased LVMI and increased RWT).
• Concentric Remodeling (CR): (Normal LVMI and increased RWT).
• Eccentric Hypertrophy (EH): (Increased LVMI and normal RWT).
• Normal Geometry (N): (Normal LVMI and normal RWT).
Hypertension can lead to both left ventricular diastolic and systolic dysfunction but diastolic dysfunction appears earlier, preceding the development of left ventricular hypertrophy and systolic dysfunction. Although systolic function is normal in most hypertensive patients, it maydeteriorates and leads to symptoms and signs of congestive Heart failure and this called systolic Heart failure.
The aim of the study is to describe the relationship between left ventricular geometry and the myocardial performance index among hypertensive patients.
Our study included 100 Hypertensive subject who SBP ≥ 140 mmHg and DBP ≥ 90 mmHg or a condition for which a patient is receiving therapy for the indication of BP lowering and 30 Normal subject who volunteer from patients relatives and nursing staff as a control group a comparing with on LVH hypertensive patients. All subjects whom included in this study were informed and taken a verbal consent. Exclusion criteria included patients with diabetes mellitus, history of chronic renal failure, ischemic heart disease, heart failure, valvular heart disease causing LVH and QRS complex duration > 120 ms. Adult hypertensive subjects who were at least 18 years old and who were willing to participate in the study were included.
All patients were subjected to the full history taking, full clinical examination, routine laboratory investigations, twelve lead standard resting ECG and Echocardiography.
Echocardiography studies were done for all subjects by:
2D and M-mode to obtained the following measurements according to ASE guidelines; IVSTd, LVIDd, PWTd, IVSs, LVIDs and PWTs. From these variables we can calculated the EF, FS, LVM and RWT and LVM which indexing to height 2.7 and giving the LVMI.
On 5-chamber view, the transducer was positioned between the LVOT and the mitral valve, the followings time intervals were measured (IVCT, ET and IVRT) and MPI was calculated to represent the systolic and diastolic function of the left ventricle (LV).
Hypertension is associated with high prevalence of abnormalities of the left ventricular performance and structure including LVH, LV diastolic and systolic dysfunction.
Initially, LVH is regarded as adaptive process; once the critical mass is exceeded, it becomes a disease. According to LVMI and RWT, there are four types of left ventricular geometric patterns:
• Concentric Hypertrophy (CH): (Increased LVMI and increased RWT).
• Concentric Remodeling (CR): (Normal LVMI and increased RWT).
• Eccentric Hypertrophy (EH): (Increased LVMI and normal RWT).
• Normal Geometry (N): (Normal LVMI and normal RWT).
Hypertension can lead to both left ventricular diastolic and systolic dysfunction but diastolic dysfunction appears earlier, preceding the development of left ventricular hypertrophy and systolic dysfunction. Although systolic function is normal in most hypertensive patients, it maydeteriorates and leads to symptoms and signs of congestive Heart failure and this called systolic Heart failure.
The aim of the study is to describe the relationship between left ventricular geometry and the myocardial performance index among hypertensive patients.
Our study included 100 Hypertensive subject who SBP ≥ 140 mmHg and DBP ≥ 90 mmHg or a condition for which a patient is receiving therapy for the indication of BP lowering and 30 Normal subject who volunteer from patients relatives and nursing staff as a control group a comparing with on LVH hypertensive patients. All subjects whom included in this study were informed and taken a verbal consent. Exclusion criteria included patients with diabetes mellitus, history of chronic renal failure, ischemic heart disease, heart failure, valvular heart disease causing LVH and QRS complex duration > 120 ms. Adult hypertensive subjects who were at least 18 years old and who were willing to participate in the study were included.
All patients were subjected to the full history taking, full clinical examination, routine laboratory investigations, twelve lead standard resting ECG and Echocardiography.
Echocardiography studies were done for all subjects by:
2D and M-mode to obtained the following measurements according to ASE guidelines; IVSTd, LVIDd, PWTd, IVSs, LVIDs and PWTs. From these variables we can calculated the EF, FS, LVM and RWT and LVM which indexing to height 2.7 and giving the LVMI.
On 5-chamber view, the transducer was positioned between the LVOT and the mitral valve, the followings time intervals were measured (IVCT, ET and IVRT) and MPI was calculated to represent the systolic and diastolic function of the left ventricle (LV).
Other data
| Title | The Effect of Left Ventricular Geometry on Myocardial Performance Index in Hypertensive Patients | Other Titles | تأثيرالشكل الهندسي للبطين الأيسرعلى مؤشرأداءعضلة القلب في المرضى الذين يعانون ارتفاع ضغط الد م | Authors | Mohammed Yasser Allam | Issue Date | 2016 |
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