Diastolic Dysfunction in Left Ventricular Hypertrophy in Hypertensive Patients with Normal Ejection Fraction

Background: Hypertension is the main cause of death and left ventricular (LV) diastolic dysfunction. LV hypertrophy (LVH) in the hypertensive patient has two types: eccentric and concentric which are classified according to the posterior wall thickness to LV end-diastolic dimensions. Aim of Study: The left ventricular diastolic function in age- and sex-matched patients with hypertension and and normal left ventricular ejection fraction was compared in the study. Patients and Methods: A total of 110 patients were enrolled in this study in Ibn Al-Bitar Cardiac Center from April 2013 to June 2014. History and examination were performed on each patient, then LV mass index (LVMI) was measured by echocardiography and patients were classified into two groups eccentric and concentric LVH. LV diastolic function was differentiated using echocardiography by measurements of left atrial volume index (LAVI), E wave, and A waves, the (E/A) ratio, transmitral deceleration time (DT), e' wave and the (E/e'). Results: LVMIs did not differ between the concentric and eccentric LVH groups. The diastolic function parameters such as LAVI, E/A ratio DT, and e' wave did not differ in both groups. Concentric LVH has E/e' significantly higher (mean ± standard deviation [SD] =12.82 ± 4.4) than those with eccentric LVH (mean ± SD = 10.37 ± 3.2). Conclusion: In patients with hypertension and LVH, concentric LVH group may be susceptible to worse diastolic dysfunction of LV than the eccentric LVH group with a similar LVMI, so we can predict the severity of diastolic dysfunction (higher E/e' ratio) by classifying LVH into concentric and eccentric.