Characterisation of left ventricular function by tissue Doppler imaging technique in newly diagnosed, untreated hypertensive subjects

BACKGROUND:Hypertension results in structural and functional changes in the heart. Early detection of abnormalities of cardiac structure and function is important in the assessment and treatment of hypertensive subjects. The aim of this study was to evaluate the utility of the tissue Doppler echocardiographic technique in characterising diastolic and systolic functions in untreated native black African hypertensive subjects.MATERIALS AND METHODS:Forty consecutive, newly diagnosed, untreated hypertensives with adequate conventional echocardiographic (2-D, M-mode, transmitral and pulmonary Doppler flow velocities) and tissue Doppler echocardiographic images were recruited into the study. The control subjects were apparently normal individuals. Each arm of the study consisted of 21 male and 19 female subjects.RESULTS:The two groups were comparable by age (48.6 +/- 11.35 years in the hypertensives vs 48.1 +/- 11.33 years in the controls; p = 0.844) and gender distribution (M/F: 21/19 in both groups). Other baseline characteristics, except for blood pressure parameters, which were predictably higher in the hypertensive subjects, were comparable between the two groups. The hypertensive subjects had a lower systolic myocardial velocity (Sm) and early diastolic myocardial velocity (Em) in comparison with the controls (p = 0.033 and p = 0.018, respectively). The late diastolic myocardial velocity (Am) was comparable in the two groups (p = 0.430). CONCLUSIONS:Tissue Doppler echocardiography demonstrates diastolic dysfunction relatively early in native African hypertensives and may be useful for detecting subtle deterioration in systolic function

The role of hypertension in dilated cardiomyopathy: an echocardiographic assessment

Follow-up and radiological studies have been carried out in the past speculating on the interlationship between hypertension and dilated cardiomyopathy; and what proportion of the later would be predominantly blamed on the former. Follow-up studies have the problem of time and drop-out rate to contend with; while radiological features pathognomonic of hypertension. A 2-D echocardiographic study of cases of biventricular failure due to hypertension and dilated cardiomyopathy (because at point of admission; no cause was evident) was undertaken to see what if any relationship exists. Certain echo indices were found to be indicative of significant hypertension in patients diagnosed as having biventricular failure due to dilated cardiomyopathy. Using this method it would be possible to tell the dilated cardiomyopathy patient who will benefit at onset from some form of antihypertensive therapy

Les complications cardiaques de l'hypertension arterielle chez 392 Noirs Africains

Les auteurs evaluent les complications cardiaques de l'hypertension arterielle a la lumiere des donnees cliniques; electrocardiographiques et radiologiques a partir de 392 admissions pour HTA au service de cardiologie du CHU Ignace Deen de Conakry (R. Guinee) de 1981 a 1988. Trois cent cinquante quatre cas de complications cardiaques (90 pour cent) ont ete colliges. Chez 38 patients (10 pour cent); la maladie n'etait pas compliquee. Les complications cardiaques ont ete diagnostiquees chez 228 hommes (64 pour cent) et 126 femmes (36 pour cent). Le pic de preference est observe a 51-60 ans pour les deux sexes (44 pour cent des cas). La cardiopathie hypertensive avec insuffisance cardiaque decomposee (349 cas) est la forme clinique la plus frequente

A study of the effect of nifedipine in reversing left ventricular hypertrophy in hypertensive patients

Using WHO hypertensive criteria; 184 patients with hypertension were chosen (102 male; 82 female); aged 58-78 years old. Other heart diseases were ruled out by physical examination; electrocardiographic examination; chest-ray and echocardiography. All the cases had one or more criteria of left ventricular hypertrophy (LVH): Interventricular septal thickness at diastole; left ventricular posterior wall thickness at end diastole and left ventricular mass index. The findings in this study imply that it is good practise to include nifedipine in the treatment regimen of patients whose hypertension is complicated with LVH and (or) ischaemic heart disease