Assessment of myocardial diastolic function in adolescents with essential hypertension

Background. Left ventricular diastolic dysfunction is a clinically significant impairment characterized by a reduced ability of the myocardium to fill adequately during the diastolic phase. One of the primary etiological factors contributing to this condition is hypertension, which, through chronic elevation of blood pressure, induces structural and functional myocardial changes. The purpose was to assess left ventricular diastolic function in adolescents with essential hypertension depending on the patterns of myocardial remodeling. Materials and methods. The study included 20 adolescents aged 14–18 years diagnosed with hypertension and 20 healthy individuals in the control group. Morphological and functional cardiac parameters were evaluated via echocardiography. Left ventricular diastolic function was assessed using pulsed Doppler imaging of transmitral flow from the apical four-chamber view. Results. The findings indicate that the type of myocardial remodeling significantly influences the development of diastolic dysfunction in adolescents with hypertension. However, even within a single remodeling type, variability in the manifestations of diastolic dysfunction was observed, accompanied by specific changes in relevant parameters. A marked trend toward pathological values of the E/A ratio was noted in all adolescents with hypertension, regardless of pattern of the left ventricular geometry remodeling. Conclusions. The development of diastolic dysfunction in hypertensive adolescents results from the complex interplay of various pathophysiological factors, which differ across patient subgroups. Comprehensive and large-scale studies are required to further elucidate these mechanisms.