The relationship between left ventricular geometric remodeling and cardiac function in essential hypertension.

BACKGROUND: Abnormal left ventricular (LV) diastolic relaxation is an early sign of hypertensive heart disease. Whether diastolic dysfunction differs between LV geometric patterns remains controversial. METHODS AND RESULTS: We examined 220 hypertensive patients by echocardiography to assess the relationship between diastolic function and LV geometric pattern. We identified four LV geometric patterns: normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy. Diastolic function was evaluated by the E/A ratio, E wave deceleration time (Dct), and isovolumic relaxation time (IRT). The E/A ratio was below one and Dct was prolonged in each group. The duration of IRT in the concentric and eccentric hypertrophy groups was significantly longer than that in normal geometry and concentric remodeling groups (p < 0.05). CONCLUSIONS: Hypertensive patients may be possible to have diastolic dysfunction, regardless of the differences in their structural geometry. The degree of impairment of cardiac diastolic function differed between hypertensive patients with different LV geometric patterns.