Cor Vasa 2018, 60(2):e139-e143 | DOI: 10.1016/j.crvasa.2017.07.002

Inappropriate left ventricular hypertrophy as a tool for risk stratification in patients with essential hypertension

Sergiy Lozinsky

Vinnytsya Pirogov Memorial National Medical University, Vinnytsya, Ukraine

The alternative method of appropriate left ventricular mass prediction in subjects with normal BP and arterial hypertension was proposed. Also the associations of new indicator of LVM inappropriateness with myocardial infarction, stroke and persistent atrial fibrillation were studied.
The study consisted of 2 stages. On the first stage 630 untreated hypertensive patients and 206 normotensive persons were studied using methods of office blood pressure (OBP) measurement, echocardiography, ambulatory blood pressure monitoring (ABPM) and noninvasive central pulse wave analysis (CPWA). Moderate significant correlation (r = 0.58; p = 0.002) between the left ventricular mass index (LVMI) and the product of systolic blood pressure (SBP) and end diastolic dimension (EDD) was found. This correlation was substantially stronger than correlations of LVMI with each of the above mentioned predictors apart and, besides, it was non-inferior compared with existing method for calculation of inappropriate LVM. We established that proposed formula could be improved by using ABPM or noninvasive CPWA parameters. On the second stage of the study 132 patients with essential hypertension, who repeatedly referred to the hospital, were divided depending on LVMI appropriateness. In all of them such events as myocardial infarction (MI), stroke or permanent AF during the period of ≈5 years were recorded. According to our data, inappropriate LVMI was associated with a higher risk of MI especially in patients without LV hypertrophy.

Received: November 13, 2016; Revised: July 9, 2017; Accepted: July 13, 2017; Published: April 1, 2018  Show citation