LV GEOMETRY CALCULATOR FULL
All patients had fasting blood sugar, fasting lipid profile, electrolytes, urea and creatinine, and full blood count assessed. The study was approved by the University of Abuja Teaching Hospital Ethics Committee. The study was carried according to the guidelines and declaration of Helsinki, and all participants provided written informed consent. 15 Detailed clinical data were obtained using case report forms given to the subjects on entry. The diagnosis of hypertension was made according to the seventh guidelines of the Joint National Committee. The 167 patients excluded were those with a clinical history of angina, ECG features of myocardial infarction and/or elevated cardiac troponin I (>0.5 ng/mL), those with heart failure, stroke, diabetes, chronic kidney disease, or serum creatinine greater than 2 mg/dL, and those with regional wall motion abnormalities on the transthoracic echocardiogram. Out of 2001 subjects who were initially recruited for the study, 1834 were enrolled. This is a prospective cohort study of new hypertensive out-patient referrals from both Family and General Physicians (from April 2006 to August 2014) to the Cardiology Clinic of University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria. 10- 13 The present study compares the 2 most widely used methods in cardiovascular medicine for indexing LVM 6, 7, 14 on the distribution of abnormal LV geometric patterns, in a large sample of untreated asymptomatic Black hypertensive subjects. Other studies on LVM indexation in this population group used only LVM indexed for BSA, with no comparison to other methods of indexation.
5- 8 However, no large-scale study has evaluated the effect of different indexation methods and partition values for LVH in hypertensive Black Africans. Therefore, the prognostic impact of LV geometry does not only depend on LVM but also on volume overload.ĭifferent partition values have been used in different studies to characterize LV geometric patterns. 5- 8 The study by de Simone et al, 9 using the Dallas Heart Study classification, has further described the mechanism of geometric adaptation in hypertension, by showing that at any given normal ejection fraction, the balance between volume load co-existing and pressure overload of hypertension influences the shape of LV geometric adaptation and the amount of left ventricular mass (LVM) and can impact prognosis. Those with eccentric hypertrophy have intermediate risk, while those subjects with normal LV geometric pattern have the lowest risk of cardiovascular events. 4 This classification is important, as several studies have shown that subjects with concentric hypertrophy have the highest risk of cardiovascular events and deaths compared with those with concentric remodeling. 1- 3 LVH is often further classified according to geometric pattern into 4 types: concentric hypertrophy, eccentric hypertrophy, concentric remodeling, and normal geometry. Left ventricular hypertrophy (LVH), as assessed by echocardiography, has been shown to be a strong and independent predictor of adverse prognosis in cardiovascular disease. In addition, LVM indexed for height 2.7 was found to be a better method for detecting LVH than LVM indexed for BSA, as the highest prevalence of abnormal geometry was diagnosed when LVM was indexed for height 2.7. In a large cohort of hypertensive subjects with no clinical evidence of cardiovascular disease, abnormal LV geometry was found in greater than four-fifths of the population. LVM/height 2.7 was a better method to detect abnormal geometric pattern than LVM/BSA ( P < 0.0001). Concentric hypertrophy was the commonest geometric pattern and was detected in 33.6% to 39.5% of the patients. LVM indexation was classified into 4 geometric patterns after echocardiography: normal geometry, concentric hypertrophy, concentric remodeling, and eccentric hypertrophy. Methods and ResultsĪll patients with hypertension referred to the Cardiology unit of University of Abuja Teaching Hospital, Abuja, Nigeria from 2006 to 2013, who gave informed consent, and underwent physical examination and echocardiography. Worksheet works.Our aim is to compare the impact of the 2 most widely used methods of indexing left ventricular mass (LVM) on the distribution of abnormal left ventricular (LV) geometric patterns, in a large sample of untreated asymptomatic black hypertensive subjects.
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