Evaluation Of Left Ventricular Diastolic Function Between Eccentric And Concentric Left Ventricular Hypertrophy In Hypertensive Patients Using Doppler Echocardiography

Purpose This study was conducted by statistic analysis of general information of primary hypertension patients,observes left ventricular diastolic function and left ventricular structure by the application of ultrasonic echocardiography.To evaluate the alteration of left ventricular diastolic function during left ventricular geometric remodeling in essential hypertension,so as to provide the basis for left ventricular diastolic function damage evaluation.The purpose of the present study was to explore the relationship between left ventricular diastolic dysfunction and left ventricular hypertrophy geometry in essential hypertensive patients.Methods A total of 246 patients with essential hypertension were selected and divided them into four groups in the research during March 2015 and May 2016.There are 67 patients with normal left ventricular geometry,54 patients with left ventricular remodelling,58 patients eccentric with left ventricular hypertrophy and 67 patients concentric with left ventricular hypertrophy.The Philips i E Elite system was used,which was equipped with S5-1 transducer(1.0-5.0MHz).The parameters of ultrasonic cardiogram examination included routine 2D ultrasound measurement of left ventricular end-diastolic dimension(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left arterial dimension(LAD).The left ventricular ejection fraction(LVEF)was calculated according to the Simpson rule.The peak velocity of early rapid filling wave(E-wave velocity)and peak velocity of the late filling wave due to atrial contraction(A-wave velocity),E/A velocity ratio were measured using conventional mitral flow doppler.The mitral annular velocity: early diastolic tissue velocity(Em),E/Em were obtained using pulsed-wave tissue Doppler imaging(PW-TDI).All patients were recorded general conditions including height,weight,heart rate,body surface area(BSA),body mass index,(BMI).The blood pressure were measured.Results There were no significant differences in systolic and diastolic blood pressures,heart rate or BMI among the four groups.(P>0.05).There were similar increases in IVST and LVPWT from group to group as follows: normal left ventricular geometry group< concentric left ventricular remodelling group<eccentric LVH group<concentric LVH group(P <0.01).Compared with the normal left ventricular geometry group and the concentric left ventricular remodelling group,the eccentric left ventricular hypertrophy(LVH)group had a significantly higher LVEDD.(P <0.01).LVEDD was significantly lower in the concentric LVH group than the eccentric LVH group.(P <0.01).The concentric LVH group had a significantly higher LVEDD(P < 0.01)than the concentric left ventricular remodelling group,(P <0.01).Left ventricular systolic function did not significantly differ among the four groups.(P>0.05).Compared with the normal Left ventricula geometry group,the eccentric and concentric left ventricular hypertrophy groups had significantly lower values for two parameters reflecting left ventricular diastolic function(E/A,P<0.01;Em,P<0.01,).E/ Em was significantly higher in the concentric left ventricular hypertrophy groups compared with the eccentric left ventricular hypertrophy groups(P<0.01).Conclusion.The study showed that E/Em measured by using Doppler was significantly higher in hypertensive patients with concentric left ventricular hypertrophy than in those with eccentric left ventricular hypertrophy.Among hypertensive patients with left ventricular hypertrophy,those with concentric left ventricular hypertrophy have more severe left ventricular diastolic dysfunction than those with eccentric left ventricular hypertrophy.Left ventricular hypertrophy geometry,as assessed by relative left ventricular wall thickness,is an important factor in assessing the severity of left ventricular diastolic dysfunction in hypertensive patients.