INFLUENCE OF LEFT-VENTRICULAR HYPERTROPHY ON THE DIASTOLIC PERFORMANCE IN HYPERTENSIVE PATIENTS AND IN ATHLETES

The aim of the study was to investigate whether the aetiology of left ventricular hypertrophy (LVH) is related with distinct abnormalities o f left ventricular diastolic performance. Methods: thirty patients wit h mild to moderate essential hypertension (15 without echocardiographi c evidence of LVH and 15 with LVH) and 15 athletes with LVH were studi ed. Control group comprised 10 normotensive subjects. By means of echo cardiography, the dimensions (EDD, ESD) the wall thickness (IVST, PWT) and their ratio (IVST/PWT), the ejection fraction (EF), the mass (LVM ) and the index mass (I mass) of the left ventricle (LV) as well as th e dimension (LA) and the emptying index (LAEI) of the left atrium were measured. From the first derivative of the apexcardiogram the alb and ef/ZN indices were estimated. Results: in hypertensive patients, with or without LVH, a decrease of LAEI and increases of alb and ef/ZN ind ices were found, compared to normotensive subjects. In contrast, no si gnificant differences were observed between athletes with LVH and norm otensive subjects. Conclusions: in hypertensive patients the diastolic performance of the LV, as derived from the alterations of the indices LAEI, a/b and ef/ZN appears to be impaired at an early stage. This al teration may be related with the increased afterload and diminished di astolic compliance of the LV. In contrast, LV diastolic performance in athletes, even in the presence of LVH, is not affected possibly becau se fibrosis of the hypertrophic myocardium is less pronounced not affe cting LV diastolic compliance.