RESUMEN
BACKGROUND: Left ventricular (LV) diastolic dysfunction has often been described in arterial hypertension in either the presence or the absence of LV hypertrophy. Impairment of LV relaxation have been recently described in obese normotensive individuals, and the prevalence of overweight to frank obesity in hypertensive populations is very high, obesity might well be an important confounder for the evaluation of LV diastolic dysfunction in the patients with hypertension. Accordingly, we designed this study to assess the effect of obesity on LV relaxation and filling in arterial hypertension. METHODS: We assessed the relations of left ventricular filling to load and geometry by Doppler echocardiography in 73 normotensive subjects (40 normal-weight [50 +/- 11 years, 22 women] and 33 obese [57 +/- 11 years, 27 women]) and 81 hypertensive subjects without silent coronary heart disease (23 normal-weight [59 +/- 7 years, 13 women] and 58 obese [54 +/- 13 years, 30 women]). RESULTS: Isovolumic relaxation time (IVRT) was prolonged in hypertensive subjects and normotensive obese subjects compared with normotensive normal-weight subjects (all p<0.01). After controlling for age, height, blood pressure, LV mass index, body mass index, between-group differences in IVRT, peak early transmitral flow velocity, the deceleration time (DT) of early filling velocity, and the ratio of early to late left ventricular filling were disappeared. CONCLUSION: Isovolumic relaxation time (IVRT) is prolonged in both arterial hypertension and obesity, and the presence of obesity does not significantly increase isovolumic relaxation time in hypertension, and abnormalities of left ventricular filling in arterial hypertension are offset after controlling for left ventricular mass.