Impairement of long axis function in arterial hypertension with apparentlynormal systolic function

Left ventricular (LV) transverse function is often used by the echocardiogr aphy to evaluate the systolic function in arterial hypertension (HTN). It w ould be interesting to know whether the LV long axis systolic dysfunction m ay precede the abnormalities ties of the transverse function in hypertensio n (HTN). For that purpose we evaluated by echo 36 patients (24 males, 12 fe males) with LV concentric hypertrophic (Lvmi>134 g/m(2) for men and >110 g/ m(2) for women). All subjects were free of coronary heart disease and heart failure. According to the dimensions of the LV wall chickness (WTh) the HT N were subdivided in two groups: Group 1: Wth (12-14 mm) and Group 2: WTh ( >14 mm). The patients were compared to 30 healthy persons (control group) m atched for age and LV systolic function (Fractional Shortening). Methods : LV long axis shortening was measured at the septal and lateral si des of the mitral annulus using M-mode from the apical four chamber view. Results : Compared to control group, septal long axis shortening fell signi ficantly (p<0.05) in proportion to the degree of the wall thickness: contro l group: 21+/-2 mm, Group 1: 16+/-1 mm and Group 2: 14+/-1 mm. Lateral shor tening was reduced only in the Group 2 (15+/-2 vs 20+/-2 mm) (p<0.05). LV w all thickness correlated significantly (p<0.05) to septal and lateral short ening respectively (r=-0.51) and (r=-0.48). Conclusions : 1, Significant impairment of LV long axis function occurs in arterial hypertension with concentric hypertrophy even with normal transver se systolic function, 2. This alteration seems to be related to the dimensi ons of the LV wall thickness. 3. The prognostic implication of this disorde r should be investigated further.