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Wiener klinische Wochenschrift

, Volume 119, Issue 13–14, pp 423–427 | Cite as

Left ventricle diastolic dysfunction in obese patients with newly diagnosed arterial hypertension

  • Viktor Persic
  • Alen Ruzic
  • Bojan MileticEmail author
  • Sanja Balen
  • Zeljko Jovanovic
  • Aleksandar Vcev
  • Sanjin Racki
  • Bozidar Vujicic
Original Article

Summary

BACKGROUND: The frequent coexistence of obesity and arterial hypertension is well known. Although both conditions have been identified as independent risk factors for impaired left ventricular diastolic function, there is a paucity of data on the dysfunction among obese patients with newly diagnosed arterial hypertension. The study was performed to determine the prevalence of diastolic dysfunction in obese individuals with newly diagnosed arterial hypertension and to compare it with the prevalence in normotensive obese persons. METHODS: We enrolled 125 obese patients: 65 with newly diagnosed hypertension and 60 normotensive patients matched for age, sex and body mass index. Left ventricular diastolic function was assessed from the following Doppler-echocardiographic measurements: mitral inflow velocities (E and A wave), E wave deceleration time, isovolumetric relaxation time, left atrial and left ventricular diameters, left ventricular wall thickness and left ventricular heart mass index. Diastolic dysfunction was considered when the E/A ratio was <1. RESULTS: We found significantly higher A wave, lower E/A ratio, longer E deceleration time and a bigger left atrium in obese patients with newly diagnosed arterial hypertension. We did not find significant differences in E wave peak velocities between the two groups. Although there was no difference in left ventricle heart mass or the prevalence of left ventricle hypertrophy, the prevalence of diastolic dysfunction was higher in the group with newly diagnosed arterial hypertension. CONCLUSION: This study suggests that newly diagnosed arterial hypertension significantly contributes to impairment of left ventricular diastolic function in obese patients before development of structural aberrations detectable on echocardiography.

Keywords

Newly diagnosed arterial hypertension Obesity Left ventricle diastolic function Echocardiography Left ventricle abnormal relaxation 

Linksventrikuläre diastolische Dysfunktion bei adipösen Patienten mit neu diagnostizierter arterieller Hypertonie

Zusammenfassung

HINTERGRUND: Arterielle Hypertonie und Adipositas sind als unabhängige Risikofaktoren der linksventrikulären diastolischen Dysfunktion schon lange bekannt; ebenso bekannt ist die häufige Koexistenz von arterieller Hypertonie und Adipositas. Daten über die linksventrikuläre diastolische Dysfunktion bei adipösen Patienten mit neu diagnostizierter arterieller Hypertonie gibt es allerdings bisher nur wenige. Diese Studie wurde durchgeführt, um die Prävalenz der linksventrikulären diastolischen Dysfunktion bei adipösen Patienten mit neu diagnostizierter arterieller Hypertonie zu erheben. METHODEN: 125 adipöse Patienten wurden in unsere Studie einbezogen, davon 65 mit neu diagnostizierter arterieller Hypertonie. Alter, Geschlecht und Body Mass Index der Hypertoniker waren mit der Gruppe der 60 adipösen Nicht-Hypertoniker vergleichbar. Die linksventrikuläre diastolische Funktion wurde mittels Doppler-Echokardiographie durch Messung folgender Parameter erhoben: Geschwindigkeit des Mitral-Influx (E- und A-Welle), E-Wellen-Dezelerationszeit, isovolumetrische Relaxationszeit, linksatriale und linksventrikuläre Diameter, intraventrikuläre Septumdicke und linksventrikuläre Herzmasse. Ein E/A-Verhältnis <1 wurde als diastolische Dysfunktion aufgefasst. ERGEBNISSE: Bei neu diagnostizierten adipösen Hypertonikern wurden signifikant höhere A-Wellen, signifikant niedrigere E/A Verhältnisse, signifikant längere E-Wellen-Dezelerationszeiten und signifikant größere linke Vorhöfe gefunden. Die Spitzengeschwindigkeit der E-wellen unterschied sich nicht signifikant. Auch in der Prävalenz der linksventrikulären Hypertrophie und der linksventrikulären Herzmasse wurde kein signifikanter Unterschied gefunden. Die Prävalenz der diastolischen Dysfunktion war bei den adipösen Patienten mit neu diagnostizierter arterieller Hypertonie signifikant häufiger. KONKLUSION: Die Studie weist auf einen signifikanten Beitrag der neu diagnostizierten arteriellen Hypertonie zur Verschlechterung der diastolischen Funktion des linken Ventrikels bei adipösen Patienten – noch vor dem Nachweis struktureller Änderungen – hin.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Viktor Persic
    • 1
  • Alen Ruzic
    • 1
  • Bojan Miletic
    • 1
    Email author
  • Sanja Balen
    • 2
  • Zeljko Jovanovic
    • 1
  • Aleksandar Vcev
    • 3
  • Sanjin Racki
    • 4
  • Bozidar Vujicic
    • 5
  1. 1.Department of CardiologyThalassotherapia OpatijaCroatia
  2. 2.Department of TransfusiologyClinical Hospital Center RijekaCroatia
  3. 3.Clinic for Internal MedicineClinical Hospital OsijekCroatia
  4. 4.Clinic for Internal MedicineClinical Hospital Center RijekaCroatia
  5. 5.Health Center UmagCroatia

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