Influence of left ventricular geometry on regional systolic and diastolic function in patients with essential hypertension.

OBJECTIVE: In essential hypertension, especially in concentric hypertrophy, global diastolic function is impaired. But, whether the left ventricular (LV) geometric pattern influences regional systolic and diastolic function or not, is unknown. This study was aimed to evaluate the influence of left ventricular geometric pattern on regional systolic and diastolic function in hypertensive patients.

DESIGN: Ninety untreated mild to moderate hypertensive patients were studied. M-mode parameters, standard Doppler and PW tissue Doppler indices were measured. Patients were divided into four groups according to left ventricular mass index and relative wall thickness: normal geometry (n = 16), concentric remodeling (n = 16), eccentric hypertrophy (n = 32) and concentric hypertrophy (n = 26).

RESULTS: Age, gender, body mass index, systolic and diastolic blood pressure were similar among groups. E/A ratio was significantly lower in the concentric hypertrophy group compared with the normal geometry group. Em velocity and Em/Am ratio in basal septum and Em velocity in basal inferior were statistically lower in the concentric hypertrophy group compared with the normal geometry group. In the concentric hypertrophy group, the number of segments with diastolic dysfunction was significantly higher compared with the normal geometry group. LV ejection fraction and regional S velocity could be compared among groups.

CONCLUSION: LV regional diastolic function is being impaired in concentric hypertrophy. LV regional systolic function does not show a difference according to the LV geometric pattern.