Wojciech Myśliński, Jerzy Mosiewicz, Andrzej Biłan, Bogusław Makaruk, Robert Palusiński, Wojciech Barud, Stanisław Ostrowski, Wojciech Sadolski, Janusz Hanzlik
Med Sci Monit 1996; 2(4): CR441-446
The purpose of the present study was to assess left ventricular (LV) structure and diastolic function in hypertensive obese patients with overweight. The study group consisted of 31 patients with mild to moderate essential hypertension and body mass index (BMI) above 26 kg/m2,. All patients were in sinus rhythm. No symptoms of congestive heart failure, ischaemic heart disease, valvular disease, endocrinopathy or lung disease were found. Eighteen subjects with mild to moderate essential hypertension and BMI below 26 kg/m2, served as controls. M-mode echocardiographic examinations evaluating LV structure and systolic function were performed. Using pulsed Doppler echocardiography peak early (MVE) left ventricular filling velocity, peak atrial (MVA) velocity, MVE/MVA velocities ratio, early and atrial waves velocity-time integrals (MVTI-E and MVTI-A) and MVTI-E/MVTI-A ratio were measured. Hypertensive obese patients with overweight had a thicker LV posterior wall (mean, 11.16 mm vs 9.75 mm, p=0.039) and enlarged left atrium (39.3 mm vs 35.71, p=0.046) compared to controls. LV diastolic diameter was 49.63 mm in the study group and 48.4 mm in controls (NS). There were no differences regarding intraventricular septum diameter and LV systolic function. MVTI-E, MVTI-E/MVTI-A and MVE/MVA ratios were significantly lower in hypertensive obese patients (p=0.02; 0.01 and 0.009, respectively), when compared to patients with normal weight. The data obtained from pulsed-Doppler echocardiography indicate that patients with systemic hypertension and obesity demonstrate more severe impairment of LV diastolic function compared to patients with hypertension and normal weight. M-mode echocardiography shows that hypertensive obese patients have a thicker posterior wall and enlarged left atrium, while the echocardiographic parameters of left ventricular systolic function remain unchanged in both groups.
Keywords: Hypertension, Obesity, left ventricular performance, Doppler echocardiography