Article

Abstract

Hypertension (HTN) is one of the most common cardiovascular diseases and causes cardiovascular death globally. Target organ damage needs to be evaluated in which cardiac function is an important point. The electrocardiogram and echocardiogram are routine tests, those are easy to perform and provide many important parameters for evaluating left ventricular systolic and diastolic function. In the world, many authors are interested in diastolic dysfunction in patients with essential hypertension. In Vietnam, there are relatively few studies on this group of patients, this study aims to evaluate clinical and subclinical characteristics in hypertensive patients with diastolic dysfunction.
Objectives: To evaluate clinical characteristics, echocardiographic parameters and 12-lead standard electrocardiogram in hypertensive patients with diastolic dysfunction.
Methods: A cross-sectional descriptive study on 169 patients with essential hypertension, including 85 patients with diastolic dysfunction and 84 patients without diastolic dysfunction. The patients were examined, taken medical history and indicated for electrocardiogram, transthoracic echocardiogram, basic blood test.
Results: The mean age was 63.3 ± 10.6 years. The group with stage 2 of left ventricular diastolic dysfunction had a higher mean age than the group without diastolic dysfunction (71.8 ± 8.8 yearrs versus 59.3 ± 10.4 years). The proportion of females is 59.8% and of male is 40.2%. The prevalence of overweight in the group with left ventricular diastolic dysfunction was higher than in the group without diastolic dysfunction (53.1% versus 46.9%). All patients in study had concentric left ventricular wall thickening
with RWT > 0.42, the group with stage 2 of left ventricular diastolic dysfunction had a higher rate of left ventricular hypertrophy than the group without diastolic dysfunction (54.1% and 25% with p < 0.001). The left ventricular diastolic dysfunction group had a larger left atrial volume (41.7 ± 4.4 ml/m² in stage 2 group and 37.7 ± 3.7 ml/m² in stage 1 group compared with 26.9 ± 6.1 ml/m² in group without diastolic dysfunction, p<0.001). The mean heart rate of the group with diastolic dysfunction was higher (79.2 ± 8.0 bpm in stage 2 group and 77.5 ± 10.2 bpm in stage 1 group versus 70.2 ± 6.4 bpm in group without diastolic dysfunction, p < 0.01). P wave, PQ, QT, and QTc intervals were all longer in the group with diastolic dysfunction than in the group without diastolic dysfunction, although the heart rate of this group was higher, the difference was statistically significant with p <0.01. The rate of left ventricular hypertrophy based on the Sokolow-Lyon index was higher in the group with left ventricular diastolic dysfunction (29.4%) than in the group without diastolic dysfunction (13.1%), p < 0.001.

Conclusion: Hypertension patients with diastolic dysfunction had a higher mean age, BMI, and proportion of overweight. The rate of left ventricular hypertrophy on echocardiography was higher in the group with diastolic dysfunction. The mean heart rate of the group with left ventricular diastolic dysfunction was higher, the P wave duration, PQ, QT and QTc intervals were longer, the Sokolow-Lyon index of the diastolic dysfunction group was higher than the group without diastolic dysfunction.