Distribuiçäo dos padröes de geometria cardíaca ao ecocardiograma na hipertensäo essencial: impacto de dois critérios de estratificaçäo / Distribution of cardiac geometric patterns on echocardiography in essential hypertension. Impact of two criteria of stratification

ABSTRACT

PURPOSE: To evaluate 2 left ventricular mass index (LVMI) normality criteria for the prevalence of left ventricular geometric patterns in a hypertensive population ( HT ) . METHODS: 544 essential hypertensive patients, were evaluated by echocardiography, and different left ventricular hypertrophy criteria were applied 1 - classic men - 134 g/m² and women - 110 g/m² ; 2- obtained from the 95th percentil of LVMI from a normotensive population (NT). RESULTS: The prevalence of 4 left ventricular geometric patterns, respectively for criteria 1 and 2, were normal geometry - 47.7 percent and 39.3 percent; concentric remodelying - 25.4 percent and 14.3 percent; concentric hypertrophy - 18.4 percent and 27.7 percent and excentric hypertrophy - 8.8 percent and 16.7 percent, which confered abnormal geometry to 52.6 percent and 60.7 percent of hypertensive. The comparative analysis between NT and normal geometry hypertensive group according to criteria 1, detected significative stuctural differences,"( *p < 0.05)LVMI- 78.4 + or - 1.50 vs 85.9 + or -0.95 g/m² *; posterior wall thickness -8.5 + or - 0.1 vs 8.9 + or - 0.05 mm*; left atrium - 33.3 + or - 0.41 vs 34.7 + or - 0.30 mm *. With criteria 2, significative structural differences between the 2 groups were not observed. CONCLUSION: The use of a reference population based criteria, increased the abnormal left ventricular geometry prevalence in hypertensive patients and seemed more appropriate for left ventricular hypertrophy detection and risk stratification