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Abstract

It has been claimed that abnormal left ventricular filling is detectable in the early stage of hypertension. On the contrary, the relationship between diastolic dysfunction and left ventricular hypertrophy (LVH) remains todate controversial. This study has to be designed to investigate the relationship among left ventricular mass, diastolic function and extracardiac atherosclerosis in newly diagnosed hypertensives. According to the VI JNC criteria, 105 hypertensive (HT) patients (65 females and 40 males) with mean age of 53±8 years) were enrolled. Left ventricular mass (LVM),by echocardiography, and left ventricular filling through analysis of E/A ratio, by echo pulsed doppler, were calculated.According to data of our laboratory, HT patients with LVM/body surface area (mq)>125 gr/mq for males and 110 gr/mq for females were considered with LVH. Intima-Media Thickness (IMT) and /or plaque presence of both common carotid arteries were detected by ultrasound examination.According to IMT values all the subjects were subgrouped in the following groups:

GROUP A consisting of 40 HT subjects with IMT values equal to or higher than 1mm and/or with carotid plaque.

GROUP B consisting of 65 HT subjects with IMT values < 1 mm.

Our results may be summarized as follows:

  1. LVM values were significantly (p<0.05)higher and E/A ratio was significantly (p<0.05) lower in group A than group B;

  2. The prevalence of LVH in our sample of HT patients was of 52.3%(55/105). In addition, all the HT patients with LVH were further subgouped into two groups according to E/A ratio values and defined as subjects with normal or altered diastolic function.

  3. In HT patients with LVH the prevalence of altered diastolic function was of 42%(23/55).

  4. A significant (p<0.05) increase in IMT values was found in the HT patients with LVH and diastolic dysfunction rather than in the other groups.

In addition, multiple regression analysis indicated a negative and independent correlation between IMT and E/A ratio.

These data might indicate that early carotid atherosclerosis is associated to LVH and diastolic dysfunction in newly diagnosed hypertensives with LVH. In conclusion, it is possible to hypothesize that this subset of patients charactherized by LVH,diastolic dysfunction and higher values of IMT, may be considered at higher risk of cardiovascular events. In view of this,further prospective data will be necessary to confirm if it is the case.

hypertension, diastolic dysfunction, carotid intima-media thickness
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© American Journal of Hypertension, Ltd. 2001
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