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KMID : 0390619980060010029
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Journal of Cardiovascular Ultrasound
1998 Volume.6 No. 1 p.29 ~ p.37
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Left Ventricular Geometry in Essential Hypertensive Patients Versus Hemodialysis Patients
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Shin Jin-Ho
Lee Bang-Hun
Lee Kyung-Jin
Choi Jung-Hye
Lee Je
Lee Jae-Ung
Kim Kyung-Soo
Kim Soon-Gil
Kim Jeong-Hyun
Lim Heon-Kil
Park Chan-Hyun
Lee Chung-Kyun
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Abstract
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Background : In end stage renal disease, left ventricular hypertrophy developed frequently due to volume and pressure overload and other unclarified precipitating factors which could not be seen in essential hypertension. It is now well established that left ventricular hypertrophy and pattern of left ventricular geometry can influence the prognosis in essential hypertension. The aim of present study was to investigate the characteristics and prognostic significance of left ventricular hypertrophy and geometric pattern in hemodialysis patients and to compare them with essential hypertension group.
Method : One hundred and forth essential hypertensive patients and forty eight hemodialysis patients were enrolled and their lift ventricular geometric patterns(normal, concentric remodeling, concentric hypertrophy eccentric hypertrophy) were compared.
Results : 1) Mean age was higher in essential hypertension group(57.3+/-13.5 years versus 48.8+/-11.2 years) but the left ventricular mass index was higher in hemodialysis group(126.0+/-35.3g/m2 versus 142.6+/-44.4g/m2, p=0.01)
2) Among left ventricular geometric patterns in hemodialysis patients, only the prevalence of concentric hypertrophy was higher statistically compared with essential hypertensive patients(p=0.014).
3) In essential hypertension group, age(beta=0.18, p=0.016), systolic blood pressure(beta-0.40, p<0.01) and total peripheral resistance(beta=-0.45, p<0.01) were correlated with left ventricular mass index. On the other hand, mean blood pressure(beta=0.38, p<0.01), heart rate(beta=-0.39, p=0.012) and total peripheral resistance(beta-0.70, p<0.01) were correlated with left ventricular mass index in hemodialysis group.
4) The hemodynamic characteristics of left ventricular hypertrophy were similar in both groups. Cardiac index was lowest and total peripheral resistance was highest in concentric remodeling. Left ventricular mass index, left ventricular septal and posterior wall thickness were highest in concentric hypertrophy and left ventricular internal dimension was highest in eccentric hypertrophy.
5) Comparing the difference between pre- and post-dialysis, only normal pattern slightly showed decreased left ventricular internal dimension in diastole, increased relative wall thickness and increased fractional shortening.
Conclusion : It is considered that the characterization of geometric patterns of left ventricular hypertrophy and investigation of its precipitating factors in essential hypertensive patients and hemodialysis patients will be helpful to improve their mortality and morbidity.
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KEYWORD
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Left ventricular geometry, Essential hypertension, Hemodialysis
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