echocardiographic assessment of left ventricular hypertrophy among hypertensives with different categories of body mass index

Abstract

newlineThe burden of cardiovascular diseases (CVDs) are increasing and a leading cause newlineof death in India. Cardiovascular diseases comprises of a group of diseases of the heart newlineand vascular system. The major conditions are ischaemic heart disease (IHD), newlinehypertension, coronary heart disease (CHD), cerebrovascular disease (stroke) etc. newlineCardiovascular diseases constitutes one of the major causes of death and disabilities in newlinethe world. There will be rise in 60% of hypertensives by 1.56 billion in 2025 newlineworldwide. The Left ventricular hypertrophy (LVH) is one of the earliest manifestations newlineof organ damage and is a strong independent predictor of cardiovascular mortality and newlinemorbidity among hypertension individuals. Various authors in their studies have shown newlinethat the obesity is related to left ventricular (LV) hypertrophy, a potential risk factor for newlineheart failure. newlineAims and Objectives: newlineThe aim of the present study to detect left ventricular hypertrophy (LVH) and its newlinepattern in patients with different stages of hypertension along with different levels of newlineBody Mass Index (BMI) using echocardiography, with the objectives as : newline1) To study the demographic characteristics (age, gender, stages of hypertension and newlineBMI) with echocardiographic findings. newline2) To study the Prevalence of LVH in Hypertensive patients with different grades of newlineobesity by echocardiography. newline3) To evaluate the structural and functional changes among hypertensive patients newlinewith relation to their different BMI levels by echocardiography. newlineMaterials and Methods: newlineThis Cross Sectional Study carried out in the department Of Physiology and in newlinecollaboration with department of Cardiology of IMS and SUM Hospital, Bhubaneswar, newlineOdisha. The study period is from January 2015 to July 2018. Total seven hundred newlinehypertensive patients have enrolled in the study with inclusion and exclusion criteria. newlineThe anthropometric measurements as height, weight, body surface area, body mass newlineix newlineindex, blood pressure (mm Hg) were recorded. The structural and functional parameters newlineof the heart obtained by echocardiography. All procedures were followed in accordance newlinewith appropriate ethical guidelines of the institution. All the data were analyzed in SPSS newlinesoftware. newlineResults: newlineThe majority of the study participants had developed the left ventricular hypertrophy in newlinethe age group of 41-60 yrs. Almost all the echocardiographic parameters such as aortic newlineroot diameter, left arterial diameter, etc. were higher in male participants than females, newlineexcept ejection fraction and fractional shortening. The end-diastolic volume increases newlinein parallel to age, whereas the ejection fraction decreases. It was found that, a positive newlinecorrelation exists between the left atrial size, left ventricular mass index in relation to newlineage, SBP, DBP, BMI and BSA. The left ventricular structural parameters, LV mass, LVMI newline(BSA) values are significantly higher with increasing BMI. In the interpretation of left newlineventricular geometric pattern, it was found that, majority of hypertensive subjects had newlineconcentric remodeling (46.7%), followed by concentric hypertrophy (43%) and eccentric newlinehypertrophy (4.3%). The rest of the hypertensive subjects had the normal geometric newlinepattern (6%). Through the univariate and multivariate analysis, the variables like age, newlinehypertension and body mass index were significantly associated with LVH. The stage2 newlinehypertensive study subjects are 5.42 times more risk for development of LVH as newlinecompared to stage1. Similarly the obese groups are 3.67 times more risk for development newlineof LVH as compared to 1.66 times among the overweight group. The majority of study newlinesubjects (59.4%) had developed Grade2 left ventricular diastolic dysfunction and 12%