Influence of left ventricular hypertrophy on the diastolic performance in hypertensive patients and in athletes

UNLABELLED: The aim of the study was to investigate whether the aetiology of left ventricular hypertrophy (LVH) is related with distinct abnormalities of left ventricular diastolic performance. METHODS: thirty patients with mild to moderate essential hypertension (15 without echocardiographic evidence of LVH and 15 with LVH) and 15 athletes with LVH were studied. Control group comprised 10 normotensive subjects. By means of echocardiography, the dimensions (EDD, ESD) the wall thickness (IVST, PWT) and their ratio (IVST/PWT), the ejection fraction (EF), the mass (LVM) and the index mass (I mass) of the left ventricle (LV) as well as the dimension (LA) and the emptying index (LAEI) of the left atrium were measured. From the first derivative of the apexcardiogram the a/b and ef/ZN indices were estimated. RESULTS: in hypertensive patients, with or without LVH, a decrease of LAEI and increases of a/b and ef/ZN indices were found, compared to normotensive subjects. In contrast, no significant differences were observed between athletes with LVH and normotensive subjects. CONCLUSIONS: in hypertensive patients the diastolic performance of the LV, as derived from the alterations of the indices LAEI, a/b and ef/ZN appears to be impaired at an early stage. This alteration may be related with the increased afterload and diminished diastolic compliance of the LV. In contrast, LV diastolic performance in athletes, even in the presence of LVH, is not affected possibly because fibrosis of the hypertrophic myocardium is less pronounced not affecting LV diastolic compliance.