INFLUENCE OF ESSENTIAL HYPERTENSION ON RIGHT VENTRICULAR MORPHOLOGY AND FUNCTION.

ABSTRACT

Right ventricular (RV) morphologic and functional changes still remain a mystery in patients with AH. The aim of this study was to evaluate the influence of essential hypertension on RV function and morphology. 75 nonsmoker hypertensive male patients (mean age 57.13±7.27) and 25 normotensive control subjects (mean age 57.56±7.55) were recruited in a study. All participants underwent 24-hour ambulatory blood pressure monitoring. Heart ultrasonography was performed to assess RV morphology and its systolic and diastolic function. In comparison with normotensive subjects, hypertensive patients had significantly higher RV wall thickness and significantly lower TAPSE (5.36±0.98 and 19.86±2.68 vs 4.11±0.50 mm and 22.52±2.02, P<0.0001). RV hypertrophy was found in 38.66% of hypertensive subjects. EF of RV in normotensive subjects was significantly higher than in hypertensives (62.73±12.81 vs 57.58±7.53%, respectively). RV mean E/A was significantly lower in hypertensive group (1.41±0.13 vs 0.89±0.15, P<0.001). RV diastolic dysfunction was found in 54.6% and systolic dysfunction in 7% of hypertensive subjects. The RV E/e' ratio was increased in hypertensives (4.84±0.97 vs. 3.88±0.32 in the control group, P<0.05). Tricuspid and mitral E'/A' ratio was decreased in hypertensive group (0.79±0.13 and 0.90±0.19 in hypertensive vs. 1.21±0.15 and 1.29±0.15 in the control groups, respectively, P<0.001 for both). According to study data, AH affects both ventricles simultaneously and causes concentric remodeling, hypertrophy, and functional disturbances in both ventricles; hence, in comparison with systolic dysfunction, existence of diastolic dysfunction was more prevalent in hypertensive population.