SUBCLINICAL LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN HYPERTENSIVE PATIENTS IN SLEMANI CITY USING 2D ECHOCARDIOGRAPHY

Omed Hamakarem a, Kamaran Hassan b and Dana Mohammed Saeed a



a Department of Medicine, College of Medicine, University of Sulaimani. 
b Kurdistan Board of Medical Specialties Candidate.


Submitted: 28/5/2018; Accepted: 12/8/2018; Published 15/10/2018

ABSTRACT


Background 

Diastolic dysfunction refers to when the diastole part is abnormal. The ventricles do not properly relax and become stiff meaning they cannot fill with blood properly. This causes blood to “dam up” in other parts of the body. The pressure in the ventricles then increases as blood from the next heartbeat tries to enter. Diastolic dysfunction is a common problem, with many people aged older than 70 years having the condition


Objectives 

To detect subclinical left ventricular diastolic dysfunction in hypertensive patients with preserved ejection fraction using 2D echocardiography.


Methods

This is a cross-sectional study that was carried on 80 hypertensive patients referred to slemani cardiac hospital and medical emergency outpatient clinic for evaluation and treatment of hypertension and 80 age and sex-matched healthy volunteers as a control group. All subjects underwent conventional echocardiographic examination and assessment of diastolic dysfunction by 2D echocardiography according to updated Europian guidelines for diastolic dysfunction


Results

A total of one hundred sixty (160) individuals were included in the final analysis. Mean age was 55.03±7.67SD years. Males accounted for 51.9% (n=83) of the studied sample and 48.1% (n=77) were females. Fifty percent (n=80) were hypertensive (cases) and the other 50% (n=80) were non-hypertensive (controls).hypertensive patients have significantly higher rates of diastolic dysfunction (22 cases vs 12) and LVH (19 vs 5) than non-hypertensives, they also have higher mean lateral annulus velocity (8.83±2.41vs10.21±2.62 ) and TR velocity(2.28±0.37vs2.11±0.11) but smaller mean LA volume.


Conclusion

Impairment of diastolic function detected by 2D echocardiography was significantly higher in hypertensive patients (with and without LVH) compared to nonhypertensive patients. Early detection of diastolic dysfunction in hypertensive patients is necessary to prevent diastolic heart failure which is the major type of heart failure in hypertensive patients.



KEYWORDS

Hypertension, 2D echocardiography, Diastolic dysfunction, Heart failure.