Differences in Left Ventricular Diastolic Dysfunction between Eccentric and Concentric Left Ventricular Hypertrophy in Hypertensive Patients with Preserved Systolic Function

Left ventricular (LV) hypertrophy (LVH) may be eccentric or concentric (2 x LV posterior wall thickness relative to LV end-diastolic dimension <= 0.42 or > 0.42, respectively). The LV diastolic function between age-matched hypertensive patients with eccentric and concentric LVH was compared in the present study. Echocardiography was used to measure LV mass index (LV mass/body surface area; LVMI) as an index of LVH. LV diastolic function was assessed by measurements of peak early transmitral flow velocity (E)/peak late transmitral flow velocity (A) (the E/A ratio), peak early diastolic mitral annular velocity (e') and the E/e' ratio. Although LVMI, E/A and e' did not differ between the two groups, E/e' was significantly higher (worse) in patients with concentric LVH (13.4 +/- 5.4) than in those with eccentric LVH (11.1 +/- 3.6). Among hypertensive patients with LVH, those with concentric LVH may, therefore, have more severe LV diastolic dysfunction than those with eccentric LVH even if their LVMIs, which reflect the degree of LVH, are similar.