CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 1, January/February 2010
24
AFRICA
and abnormal geometry among treated hypertensives. However,
the study reported a higher prevalence among women.
33
This
was despite the use of antihypertensive drugs, although drug
adherence and compliance were not assessed in this study. Only
28% of newly diagnosed hypertensive subjects were shown to
have normal left ventricular geometry in a study from the same
centre.
34
The management of LVH and abnormal geometry there-
fore seems to be an important therapeutic goal to prevent the
progression of the condition.
Conclusion
This study further highlights the relatively increased prevalence
of left ventricular hypertrophy and abnormal left ventricular
geometric pattern among treated hypertensive Nigerian subjects.
Hypertensive subjects with eccentric hypertrophy had reduced
ejection fraction, fractional shortening and left ventricular ejec-
tion time than those with other geometric patterns. They also had
increased left atrial dimension. Eccentric and concentric hyper-
trophy were the commonest forms of left ventricular geometry
among the subjects.
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TABLE 4. COMPARING CLINICALAND ECHOCARDIO-
GRAPHIC PARAMETERS OF SUBJECTSWITH NORMAL
GEOMETRYWITHTHOSEWITHABNORMAL GEOMETRY
Variables
Normal geometry Abnormal geometry
p
Age
51.48
±
12.1
56.53
±
10.3
0.05
Duration
4.4
±
5.13
6.79
±
7.9
0.273
BSA
1.87
±
0.18
1.82
±
0.18
0.127
SBP
134.92
±
17.45
149.23
±
24.01
0.009*
DBP
86.4
±
7.6
89.62
±
12.0
0.417
EF
71.15
±
13.97
67.88
±
15.7
0.342
FS
37.92
±
12.04
33.75
±
10.03
0.057
AOD
29.62
±
5.27
31.15
±
4.63
0.298
LAD
33.55
±
4.90
36.16
±
7.3
0.070
SV
77.97
±
36.2
71.55
±
34.90
0.242
LVET
303.27
±
38.94
273.4
±
65.52
0.265
MERAT
1.31
±
0.80
1.12
±
1.19
0.49
DT
197.2
±
55.96
203.44
±
54.6
0.859
IVRT
94.46
±
22.97
104.73
±
29.73
0.081
AVV
max
1.1
±
0.19
1.19
±
0.33
0.45
AVVTI
21.44
±
4.92
22.24
±
1.01
0.02*
AVPG
max
5.16
±
2.22
6.74
±
7.6
0.55
AVV
mean
0.70
±
0.14
0.76
±
0.18
0.461
LVET Dop 293.12
±
25.81
274.95
±
47.59
0.158
LVPEP
88.94
±
2.06
95.36
±
4.04
0.360
LVSTI
1.40
±
4.67
0.34
±
0.13
0.032*
LVIDD
4.66
±
0.44
4.62
±
0.95
0.774
LVISD
2.95
±
3.16
3.16
±
1.07
0.597
IVSD
1.07
±
0.21
1.33
±
0.24
0.000*
LVM
160.84
±
35.96
234.48
±
81.84
0.000*
RWT
0.38
±
0.05
0.56
±
0.18
0.000*
LVMI
38.24
±
7.61
59.16
±
20.03
0.000*
CR: concentric remodelling, CH: concentric hypertrophy, EH: eccen-
tric hypertrophy, N: normal geometry, BSA: body surface area (m
2
),
SBP: systolic blood pressure (mmHg), DBP: diastolic blood pres-
sure (mmHg), EF: ejection fraction (%), FS: fractional shortening
(%), AOD: aortic root dimension (cm), LAD: left atrial dimension
(cm), SV: stroke volume (ml), LVET (2D): left ventricular ejection
time in 2-D echo (sec), MERAT: mitral e/a ratio, DT: deceleration
time (seconds), PHT: pressure at half time (mmHg), IVRT: isovolu-
mic relaxation time (sec), AVV
max
: maximun aortic valve pressure
(mmHg), AVVTI: velocity time interval of aortic valve (mmHg),
AVPG
max
: maximum aortic valve pressure gradient (mmHg), AVV
mean
:
mean aortic valve pressure, LVET Dop: left ventricular ejection time
with Doppler (seconds), LVPEP: left ventricular pre-ejection pres-
sure time (sec), LVSTI: left ventricular stroke–time interval gradient,
LVIDD: left ventricular internal dimension in diastole (cm), LVISD:
left ventricular internal dimension in systole (cm), IVSd: interven-
tricular dimension in diastole (cm), PWTD: posterior wall thickness
in diastole (cm), LVM: left ventricular mass (g), RWT: relative wall
thickness, LVMI: left ventricular mass index (g/m
2.7
). *Statistically
significant.
