Patterns of left ventricular geometry and color Doppler echocardiographic findings in hypertensive patients

Objective To analyze the patterns of left ventricular geometry and their mechanism of development in hypertensive patient.Methods The left ventricular mass index (LVMI) and relative wall thickness (RWT) were determined by echocardiography in 172 essential hypertensive patients and 123 normal control subjects. Whether mitral and /or aortic regurgitation exists and their severities were evaluated by color Doppler echocardiography. Also the systemic vascular resistance (SVR) was calculated by brachial blood pressure and the cardiac output determined by echocardiography in all patients and normal subjects. Different left ventricular geometric patterns were analyzed according to LVMI and RWT, together with their color Doppler echocardiographic findings and SVR features.Results There were four left ventricular geometric patterns in 172 hypertensive patients. Among them 49.42% had normal left ventricular geometric pattern, 9.30% had concentric remodeling of left ventricle, 11.63% concentric and 29.65% eccentric left ventricular hypertrophy. Moderate mitral regurgitation was more common in eccentric left ventricular hypertrophy group. While SVR was the highest in the concentric remodeling group and also high in concentric left ventricular hypertrophy and normal left ventricular group in sequence. The SVR value of these three groups in comparing to control group had significant difference (P<0.01).Conclusions In hypertensive patients, eccentric left ventricular hypertrophy is more common than concentric left ventricular hypertrophy, and left ventricular concentric remodeling also ocurrs in a certain proportion. Concentric left ventricular hypertrophy and concentric left ventricular remodeling are primarily related to the pressure overload, while eccentric left ventricular hypertrophy is related both to pressure and volume overload. Concentric remodeling of left ventricle may also be related to volume underload.