Abstract
BACKGROUND:
It is predicted that changes in LV morphology in hypertensive patients will cause a reduction in compliance and an increase in myocardial stiffness. The E/E' to (LVEDD) ratio represents the pressure–volume relationship of the LV, which was used to quantify LV stiffness.
AIM OF THIS STUDY:
Assess myocardial stiffness in hypertensive patients by applying a combined conventional and (TDI) on the pressure volume relation [(E/E')/LVEDD].
METHODS:
The research included 81 hypertensive patients (48 females and 33 males) and 33 healthy individuals (23females&10males) as a control group . A complete TTE echocardiographic examination was performed on all patients, including (TDI) of the mitral annulus, measurement of (LV) septal and posterior wall thickness, LV mass, LVEDD, and transmitral Doppler peak early (E) and late (A) diastolic filling velocities. The septal and lateral sites of the mitral annulus were used to average TDI early diastolic myocardial velocities (E').
RESULTS:
In hypertensive group, mitral annular TDI early diastolic velocity E' was significantly lower than the control group's P <0.05. Hypertensive group also showed a significantly higher late diastolic velocity compared with control group p <0.05. The mean E' was significantly lower while the mean E/E' ratio was significantly higher and the LV stiffness index was insignificantlydifferent in hypertensives compared with control subjects. In the hypertensive group, the LV stiffness was insignificantly correlated with IVS thickness.
CONCLUSION:
In hypertensive patients, LV myocardial diastolic stiffness index [(E/E')/LVEDD] is not so increased and is not correlated well with the LV wall thickness and LV mass index.
10. Nagueh, S. F., Smiseth, O. A., Appleton, C. P.,et al . Recommendations for the evaluation of left ventricular diastolic function by echocardiography. European Journal of Echocardiography. 2009;10:165-93.
11. Grohe C, Kahlert S, Lobbert K et al. Modulation of hypertensive heart disease by estrogen. Steroids .1996; 61: 201–4.
12. Aryan, L., Younessi, D., Zargari, M., Banerjee, S., Agopian, J., Rahman, S., ... & Eghbali, M.The role of estrogen receptors in cardiovascular disease. International Journal of Molecular Sciences. 2020; 21:4314.
13. Iacobellis G, Ribaudo MC, Leto G, et al: Influence of excess fat on cardiac morphology and function: study in uncomplicated obesity. Obes Res . 2002;10:767-773.
14. Pascual M, Pascual DA, Soria F, et al: Effects of isolated obesity on systolic and diastolic left ventricular function. Heart. 2003; 89:1152-56.
15. Ommen, S.R., Nishimura, R.A., Appleton, C.P., et al. "Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study". Circulation. 2000;102:1788-94.
16. Lorell, B.H., Carabello, B.A. "Left ventricular hypertrophy: Pathogenesis, detection and prognosis". Circulation. 2000;102:470-79.
17. Solomon, S.D., Verma ,A., Desai, A., et al. "Effect of intensive versus standard blood pressure lowering on diastolic function in patients with uncontrolled hypertension and diastolic dysfunction". Hypertension. 2010;55:241-48.
)
