Relationship between left ventricular diastolic function and geometric patterns in Nigerians with newly diagnosed systemic hypertension

BACKGROUND It is not known whether abnormalities of left ventricular diastolic function are influenced by the various cardiac geometric patterns in Nigerians with newly diagnosed systemic hypertension. OBJECTIVE To evaluate the relationship between the parameters of left ventricular diastolic function and the geometric patterns in this group of patients. METHODS Two-dimensional, guided M-mode echocardiography including Doppler was performed in 150 consecutive, newly diagnosed hypertensive individuals and normotensive controls aged between 35 and 74 years. Left ventricular mass index and relative wall thickness were used to classify the hypertensive individuals into four geometric patterns, and the pulsed-wave Doppler parameters obtained were used to categorise the abnormalities of diastolic function. RESULTS Four left ventricular geometric patterns were identified: 23 (15.3%) had normal left ventricle geometry, 33 (22%) had concentric remodelling, 37 (24.7%) were found to have eccentric hypertrophy, and concentric hypertrophy occurred in 57 (38%) of the hypertensive individuals. Left ventricular diastolic dysfunction occurred more in hypertensives with concentric left ventricular geometric pattern. Increased left ventricular mass index and relative wall thickness were found to be associated with the mitral E-wave, E/A ratio and pulmonary venous flow S-wave in the hypertensives (p < 0.001). CONCLUSION In newly diagnosed Nigerian hypertensives, the abnormalities in left ventricular diastolic function varied between the different left ventricular geometric patterns, being worst in those with concentric geometry.