The Influence of the Left Ventricular Geometry on the Left Atrial Size and Left Ventricular Filling Pressure in Hypertensive Patients, as Assessed by Echocardiography

다국어 초록 (Multilingual Abstract)

Background and Objectives: It is not well understood whether the left ventricular geometry is associated with
such diastolic parameters as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler
indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left
atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods:
181 patients (mean age: 63±9 years old, 62 males) with hypertension were included for echocardiographic analysis.
The hypertensive patients were classified into four groups according to the left ventricular mass index and the
relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy.
We excluded all the individuals with established cardiovascular disease, atrial fibrillation, significant aortic and/
or mitral valve disease, or an ejection fraction <50%. Results: By definition, the left ventricular mass was increased
in the patients with eccentric and concentric hypertrophy. Both the left ventricular end-systolic diameter and the
left ventricular end-diastolic diameter were reduced in the concentric remodeling group, whereas the left ventricular
end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric
hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric
hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow
velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry
to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy.
Conclusion: This study demonstrates that in a patient population with hypertension and who are without systolic
dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular
diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the
patients with eccentric and concentric hypertrophy.

다국어 초록 (Multilingual Abstract)

Background and Objectives: It is not well understood whether the left ventricular geometry is associated with
such diastolic parameters as the left atrial volume and the left ventricular filling pressure, as assessed by the Doppler
indices. Accordingly, this study aimed to evaluate the influence of the left ventricular geometry on the left
atrial volume and the left ventricular filling pressure, as assessed by the Doppler indices. Subjects and Methods:
181 patients (mean age: 63±9 years old, 62 males) with hypertension were included for echocardiographic analysis.
The hypertensive patients were classified into four groups according to the left ventricular mass index and the
relative wall thickness: normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy.
We excluded all the individuals with established cardiovascular disease, atrial fibrillation, significant aortic and/
or mitral valve disease, or an ejection fraction <50%. Results: By definition, the left ventricular mass was increased
in the patients with eccentric and concentric hypertrophy. Both the left ventricular end-systolic diameter and the
left ventricular end-diastolic diameter were reduced in the concentric remodeling group, whereas the left ventricular
end-systolic diameter and the left ventricular end-diastolic diameter were increased in the eccentric and concentric
hypertrophy groups. Compared with the patients with normal geometry, the patients with eccentric and concentric
hypertrophy demonstrated a significant higher value for the left atrial volume index. The ratio of the transmitral inflow
velocity to the mitral annular velocity (E/E’) showed a stepwise increase from the patients with normal geometry
to the patients with concentric remodeling, and then to the patients with eccentric and concentric hypertrophy.
Conclusion: This study demonstrates that in a patient population with hypertension and who are without systolic
dysfunction, the left atrial volume index and the E/E’ demonstrated a progressive worsening of the left ventricular
diastolic function from patients with normal geometry to the patients with concentric remodeling, and then to the
patients with eccentric and concentric hypertrophy.

참고문헌 (Reference)

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