Abstract 12478: Hypertension-related Left Ventricular Hypertrophy is Assossiated With Right Ventricular Dysfunction

Abstract

Introduction: In the setting of essential hypertension, left ventricular hypertrophy is a common echocardiographic finding. The functional interdependance of the two ventrincles often leads to right ventricular dysfunction.

Hypothesis: We assessed the hypothesis that Tissue Doppler Imaging (TDI) may help us study the subtle alterations of the right ventricular function in patients with hypertension-related left ventricular hypertrophy.

Methods: Our population consisted of 55 subjects (aged=51±6 years, 44 men) with newly diagnosed, untreated, stage I-II essential hypertension and 34 age- and sex-adjusted control subjects. Standard transthoracic echocardiographic measurements as well as pulsed-wave tissue Doppler from tricuspid annulus were obtained.

Results: Age and heart rate were similar between the two groups. Hypertensive subjects had significantly increased left ventricular (LV) diastolic septal and posterior wall thickness, left atrial diameter, LV mass, LV mass index and relative wall thickness. Right ventricular TAPSE and RVOTfs (%) were similar between the two groups (2.45±0.3 vs 2.25±0.23 and 47±5 vs 46±5, respectively, p= NS for all). Conventional echo Doppler study revealed similar RV peak E, A velocities as well as their ratio between the two groups. At the level of lateral tricuspid annulus, all of the diastolic measurements were altered in hypertensives [early diastolic velocity (cm/sec) 13±4 vs 18±4, p<0.01, late diastolic velocity (cm/sec) 20±3 vs 14±4, p<0.01, early to late diastolic velocity ratio 20±4 vs 14±3, p<0.01]. Systolic velocity did not differentiate between the two groups (16±3 vs 17±3, p=NS).

Conclusions: Right ventricular functional alterations can be identified by TDI imaging in hypertensives with left ventricular hypertrophy. TDI imaging unmasks sublte changes in the diastolic function of the right ventricle.