Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1984 Jun;51(6):637–642. doi: 10.1136/hrt.51.6.637

Left ventricular hypertrophy. Relation of structure to diastolic function in hypertension.

L M Shapiro, W J McKenna
PMCID: PMC481565  PMID: 6234010

Abstract

Digitised M mode echocardiography was used to determine the relation between the degree of left ventricular hypertrophy and abnormalities of isovolumic relaxation and diastolic function. Fifty six patients with varying severity of non-malignant systemic hypertension without evidence of ischaemic heart disease, left ventricular dilation, or clinical heart failure were studied. In addition, 10 athletes with hypertrophy and 20 normal subjects were studied. Athletes and patients with moderate (systolic blood pressure 175 to 200 mm Hg) and severe hypertension (greater than 200 mm Hg) had a significant increase in left ventricular mass. Cavity dimensions were normal in hypertensive patients and increased in athletes. Systolic function was normal in all groups. Regardless of the degree of hypertrophy patients with hypertension had a prolonged isovolumic relaxation period and delayed mitral valve opening. Patients with hypertrophy also had a reduced rate and prolonged duration of rapid early diastolic dimension increase and posterior wall thinning. Athletes, however, who had an equivalent degree of hypertrophy to patients with moderate or severe hypertension had entirely normal function. Measurements of diastolic function were significantly correlated with wall thickness and left ventricular mass. These indices of hypertrophy, particularly posterior wall thickness and the sum of posterior wall and septal thickness, were positively correlated with the duration of isovolumic relaxation and delay in mitral opening and negatively with the peak rate of early diastolic dimension increase and wall thinning. Thus in hypertensive patients with non-dilated left ventricular hypertrophy there appears to be a relation between the degree of wall thickening and abnormalities of diastolic function.

Full text

PDF
637

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brutsaert D. L., de Clerck N. M., Goethals M. A., Housmans P. R. Relaxation of ventricular cardiac muscle. J Physiol. 1978 Oct;283:469–480. doi: 10.1113/jphysiol.1978.sp012513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Dawson J. R., Sutton G. C. Detection of clinically significant coronary artery disease in hypertensive patients. Echocardiographic study. Br Heart J. 1981 Dec;46(6):595–602. doi: 10.1136/hrt.46.6.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Devereux R. B., Savage D. D., Sachs I., Laragh J. H. Relation of hemodynamic load to left ventricular hypertrophy and performance in hypertension. Am J Cardiol. 1983 Jan 1;51(1):171–176. doi: 10.1016/s0002-9149(83)80031-9. [DOI] [PubMed] [Google Scholar]
  4. Flohr K. H., Weir E. K., Chesler E. Diagnosis of aortic stenosis in older age groups using external carotid pulse recording and phonocardiography. Br Heart J. 1981 May;45(5):577–582. doi: 10.1136/hrt.45.5.577. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gibson D. G., Brown D. Measurement of instantaneous left ventricular dimension and filling rate in man, using echocardiography. Br Heart J. 1973 Nov;35(11):1141–1149. doi: 10.1136/hrt.35.11.1141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gibson D. G., Greenbaum R., Marier D. L., Brown D. J. Clinical significance of early diastolic changes in left ventricular wall thickness. Eur Heart J. 1980;Suppl A:157–163. doi: 10.1093/eurheartj/1.suppl_1.157. [DOI] [PubMed] [Google Scholar]
  7. Gibson D. G., Traill T. A., Hall R. J., Brown D. J. Echocardiographic features of secondary left ventricular hypertrophy. Br Heart J. 1979 Jan;41(1):54–59. doi: 10.1136/hrt.41.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Grossman W. Cardiac hypertrophy: useful adaptation or pathologic process? Am J Med. 1980 Oct;69(4):576–584. doi: 10.1016/0002-9343(80)90471-4. [DOI] [PubMed] [Google Scholar]
  9. Hanrath P., Mathey D. G., Siegert R., Bleifeld W. Left ventricular relaxation and filling pattern in different forms of left ventricular hypertrophy: an echocardiographic study. Am J Cardiol. 1980 Jan;45(1):15–23. doi: 10.1016/0002-9149(80)90214-3. [DOI] [PubMed] [Google Scholar]
  10. Mattheos M., Shapiro E., Oldershaw P. J., Sacchetti R., Gibson D. G. Non-invasive assessment of changes in left ventricular relaxation by combined phono-, echo-, and mechanocardiography. Br Heart J. 1982 Mar;47(3):253–260. doi: 10.1136/hrt.47.3.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Oldershaw P. J., Brooksby I. A., Davies M. J., Coltart D. J., Jenkins B. S., Webb-Peploe M. M. Correlations of fibrosis in endomyocardial biopsies from patients with aortic valve disease. Br Heart J. 1980 Dec;44(6):609–611. doi: 10.1136/hrt.44.6.609. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Sanderson J. E., Gibson D. G., Brown D. J., Goodwin J. F. Left ventricular filling in hypertrophic cardiomyopathy. An angiographic study. Br Heart J. 1977 Jun;39(6):661–670. doi: 10.1136/hrt.39.6.661. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Sanderson J. E., Gibson D. G., Brown D. J., Goodwin J. F. Left ventricular filling in hypertrophic cardiomyopathy. An angiographic study. Br Heart J. 1977 Jun;39(6):661–670. doi: 10.1136/hrt.39.6.661. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Shapiro L. M., Beevers D. G. Malignant hypertension: cardiac structure and function at presentation and during therapy. Br Heart J. 1983 May;49(5):477–484. doi: 10.1136/hrt.49.5.477. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Shapiro L. M. Echocardiographic features of impaired ventricular function in diabetes mellitus. Br Heart J. 1982 May;47(5):439–444. doi: 10.1136/hrt.47.5.439. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Shapiro L. M., Mackinnon J., Beevers D. G. Echocardiographic features of malignant hypertension. Br Heart J. 1981 Oct;46(4):374–379. doi: 10.1136/hrt.46.4.374. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Traill T. A., Gibson D. G., Brown D. J. Study of left ventricular wall thickness and dimension changes using echocardiography. Br Heart J. 1978 Feb;40(2):162–169. doi: 10.1136/hrt.40.2.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Tsakiris A. G., Gordon D. A., Padiyar R., Fréchette D. Relation of mitral valve opening and closure to left atrial and ventricular pressures in the intact dog. Am J Physiol. 1978 Feb;234(2):H146–H151. doi: 10.1152/ajpheart.1978.234.2.H146. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES