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Correlation of Left Ventricular Mass Index with Functional Capacity, Diastolic Parameters Changes, and Global Longitudinal Strain Based on Diastolic Stress Echocardiogrpahy in Asymptomatic Hypertensive Heart Disease Patients

Author : R. A. Fanani, A. M. Soesanto, B. Radi
Upload Date : 19-04-2018

Backgrounds: Left Ventricular Hypertrophy (LVH) is a cardiac adaptation mechanism on hypertension and relates to cardiovascular event and diastolic heart failure. However, prior studies showed various results on correlation of LVH, based on Left ventricular mass index (LVMI) measurement, with functional capacity and diastolic parameters.

Aims: To assess correlations of LVMI with functional capacity, diastolic parameters changes, and global longitudinal strain (GLS) in male asymptomatic hypertensive patients with LVH. Methods: Male asymptomatic hypertensive patients with LVMI>115 gr/m2 without history of coronary artery disease, arrhythmia, congenital heart disease, and valvular heart disease are recruited. Diastolic stress echocardiography with ramp protocol is performed. Measurement of LVMI is acquired prior to stress test, and diastolic parameters (E/A, E/e’, IVRT) and GLS are acquired at pre and peak stress test.

Results: Forty one male patients were recruited aged 55 (32-64) years old. The median of LVMI was 129 (116-319) gr/m2, with mean value of functional capacity was 5.7+1 METs. The mean of LV Ejection fraction was 68+6.1%. With pre and peak-stress test diastolic parameter values remained statistically insignificant (E/A ratio pre vs peak: 0.83 vs 0.93; p 0.542. E/e’ ratio pre vs peak: 8.9 vs 8.7; p 0.55. IVRT pre vs peak: 117 vs 120 ms; p 0.574). The pre-stress test GLS mean value was low but had significant increase at peak-stress test measurement (pre vs peak: -15.4 +3.2% vs 18.5 +3,9%; p<0.0001).  There were no significant correlations between LVMI and functional capacity (r:-0.079; p=0.62), diastolic parameters in pre and peak stress test, GLS, and diastolic parameter changes.

Conclusions: There are no correlations between LVMI and functional capacity, diastolic parameter changes, and global longitudinal strain in asymptomatic hypertensive heart disease.

KEYWORDS : Left ventricular hypertrophy, Left ventricular mass index, functional capacity, diastolic parameters, global longitudinal strain.

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