Left Ventricular Diastolic Dysfunction in Congestive Heart Failure Due to Systematic Hypertension

ABSTRACT

This was a prospective observational study was carried out in Shaheed Shaikh Abu-Naser Specialized Hospital, Khulna, Bangladesh during the period from January 2017 to December 2018. Our aim was to evaluate left ventricular diastolic dysfunction in congestive heart failure resulting from systemic hypertension. Methods: Fifty patients with systemic hypertension who had recently experienced CHF with normal ejection fraction (≥50%) and no clinical history of ischaemic cardiomyopathy were studied. The patients were divided into two groups according to the degree of echocardiographic hypertrophy group-I (26 patients) with a ventricular mass/volume ratio >1.8 and group-II (24 patients) with a ratio <1.8. Results: Group I patients had a higher ejection fraction (67.62±3.14 vs 55.33 ±4.13, P<0.001), smaller ventricular diameter (28.88+2.46 vs 34.38±4.37, P<0.001), higher LV mass (154.42±6.80 vs 123.38±5.58, P<0.001), lower ETT positivity (15%vs75%, P<0.001). Clinically, group I had more frequent audible fourth heart sound (57% vs 20%, P< 0.001), low incidence of audible third heart sound (15% vs 70%, P<0.001), ECG evident LVH mass (96% vs 16%, P<0.001), cardiomegaly (23% vs 70%, P<0.001). Conclusion: There were no significant differences between groups for NYHA class, age, sex, heart rates and systolic blood pressure but significantly associated with Diastolic BP, ECG (LVH) and Cardiomegly.