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Arquivos Brasileiros de CardiologiaResumo das Próximas Publicações
Ano 2001Distribution of Cardiac Geometric Patterns on Echocardiography in Essential Hypertension. Impact of Two Criteria of Stratification
Eduardo Cantoni Rosa, Valdir Ambrósio Moisés, Ricardo Cintra Sesso, Nárcia E. B. Kohlmann, Frida Liane Plavnik, Maria Teresa Zanella, Artur Beltrame Ribeiro, Osvaldo Kohlmann Júnior
Objective – To evaluate the use of 2 criteria for normality of the ventricular mass index regarding the prevalence of ventricular geometric patterns in a hypertensive population.
Methods – We assessed 544 individuals (371 females and 173 males) with essential hypertension on Doppler echocardiography applying 2 criteria for ventricular hypertrophy: 1) the classical criterion (Cornell) – 134g/m2 for males and 110g/m2 for females; 2) a criterion obtained based on the 95th percentile of the ventricular mass index of a normotensive population (110g/m2 and 96g/m2).
Results – We observed the prevalence of 4 left ventricular geometric patterns with criteria 1 and 2, as follows: normal geometry – 47.4% and 39.3%; concentric remodeling - 25.4% and 14.3%; concentric hypertrophy – 18.4% and 27.7%; eccentric hypertrophy – 8.8% and 18.6%. This corresponded to abnormal geometry in 52.6 % and 60.7% of the hypertensive individuals, according to criteria 1 and 2, respectively. Similar results were obtained when males and females were assessed separately. When the normotensive group (NT) was compared with the hypertensive group with normal geometry obtained according to criterion 1 (HT-NG1), we observed the following (* p<0.05): ventricular mass index – 78.4± 1.50 vs 85.9± 0.95g/m2 *; left ventricular posterior wall – 8.5± 0.1 vs 8.9± 0.05mm*; left atrium – 33.3± 0.41 vs 34.7± 0.30mm*; these differences were not expected for a group defined as having normal geometry. When we used criterion 2, no significant differences were observed between the 2 groups. Application of both criteria for the male and female groups provided similar results.
Conclusion – The use of the limits of ventricular mass index for hypertrophy based on the 95th percentile of a normotensive population increased the prevalence of hypertensive individuals with some changes on echocardiography. Detection of ventricular hypertrophy and risk stratification of hypertensive individuals based on echocardiography seemed more appropriate to us.
Key words – essential hypertension, left ventricular hypertrophy, criteria of hypertrophy
Universidade Federal de São Paulo – Escola Paulista de
Medicina
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