The relation of gender and geometry to left ventricular structure and functions in a newly presenting hypertensive population in Nigeria

Background: Studies differ on the influence of gender and geometry on the functions of left ventricle (LV). We report the relation of abnormal geometry and gender to LV structure and functions in an African population. Materials and Methods: A total of 156 consecutive newly presenting hypertensives comprising 53% females were enrolled into the study. All participants underwent full clinical evaluation, and echocardiographic examination was performed according to the American Society of echocardiography recommendation. Using LV mass index (LVMI) and relative wall thickness, 145 subjects with complete echocardiographic parameters were divided into four LV geometric patterns; normal, concentric remodelling (CR), eccentric hypertrophy, and concentric hypertrophy. Results: The mean age of the hypertensive subjects was 59.5 (12.3) years. The mean age and blood pressure (BP) indices were comparable across the gender. While males were taller, females were heavier and had wider waist and hip circumferences. Men had larger left atrium, aortic root diameter, aortic valvular opening, LV dimensions, and LVM compared with females. LV systolic and diastolic functions were similar. More than half of the subjects had abnormal geometry with CR prevalent. The subjects with concentric hypertrophy were the youngest ( P = 0.036) and had the highest mean diastolic BP ( P = 0.037). There was no significant gender influence on the distribution of geometry pattern. Left Atrial diameter and LV dimensions except posterior wall thickness at diastole were significantly larger in eccentric hypertrophy when compared with other groups ( P = 0.0001). LV ejection fraction was lowest among subjects with eccentric hypertrophy. Diastolic function parameters were comparable among the groups. Conclusion: The study showed that more than half of the study subjects had abnormal geometry even at the presentation. Abnormal geometry probably affects LV systolic function more than the diastolic filling patterns. Prompt management may alter the prognostic effect of abnormal geometry among the study group.