LEFT-VENTRICULAR HYPERTROPHY AND GEOMETRY IN A POPULATION-SAMPLE OF ELDERLY MALES

Background Recent studies have shown that left ventricular geometric a daptation to hypertension is complex. The spectrum of geometric adapta tions in a general population and its relationship to systolic and dia stolic function has, however, not been investigated. Objectives and me thods This echocardiographic and Doppler study investigated the relati onships between left ventricular geometric shape (normal, concentric r emodelling, concentric hypertrophy and eccentric hypertrophy) and left ventricular systolic and diastolic function in a population sample of 584 males aged 70 in Uppsala, Sweden. The influences of hypertension, coronary heart disease and diabetes mellitus were also evaluated. Res ults Sixteen percent of the healthy population (n= 167) demonstrated t he presence of left ventricular hypertrophy (mainly eccentric). Subjec ts with hypertension (n=115) showed an increased left ventricular mass (eccentric left ventricular hypertrophy 31%, concentric left ventricu lar hypertrophy 15%), when compared with healthy subjects (P<0.001). S ubjects with coronary heart disease (n=32) without hypertension also s howed an increased left ventricular mass (most often eccentric) (P<0.0 5). Using Doppler determinations of cardiac index, no differences were found in cardiac index between the geometric groups. Raised total per ipheral resistance, increased blood pressure and enlarged left atrium were found in both concentric and eccentric left ventricular hypertrop hy (P<0.01-0.05). Disturbed diastolic function was seen with a prolong ation of the isovolumic relaxation time in eccentric (P<0.01) and incr eased atrial-dependent left ventricular filling in concentric left ven tricular hypertrophy (P<0.05). Conclusion Alterations in left ventricu lar geometry were common in this population-based study of elderly mal es, both in healthy subjects and in subjects with hypertension or coro nary heart disease. Raised total peripheral resistance and left ventri cular diastolic dysfunction were common findings in both concentric an d eccentric left ventricular hypertrophy.