Valvular regurgitation impact on left ventricular 2-dimensional and Doppler echocardiographic indices in patients with essential hypertension
Journal of the National Medical Association
Division of Cardiology, Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria; Department of Health Studies, College of Health Sciences, Chicago State University, Chicago, IL, United States; Division of Hypertension and Clinical Pharmacolog
Background: Blacks have both a higher hypertension prevalence and accelerated cardiac end organ damage. Because blacks also have a higher prevalence of valvular heart disease, which occurs at a younger age than for whites, we further examined the contribution of valvular regurgitation to the severity of hypertensive heart disease in Nigerians. Methods: We evaluated and compared echocardiographic indexes in 75 essential hypertensive Nigerians with (n = 48) and without (n = 27) valvular regurgitations. Demographic and echocardiographic indices, as well as the types and severity of valvular lesions were compared between the groups using bivariate logistic regression and analysis of variance. Results: The 2 groups were of similar demographics, but those with regurgitations had larger cardiac size (p < .05), greater mass (147 ± 31 vs 122 ± 32 g/m 2, p = .01) higher volume (p < .01), and left atrial size (35.6 ± 4.6 vs 33.3 ± 4.6 mm, p < .05). Atrial size, cardiac volume, and dimension were independent correlates/predictors of regurgitation occurrence. Relative wall thickness of at least 0.6 was more common in regurgitation patients. Cardiac mass was correlated to increasing age (r = 0.23, p = .043). The valvular lesions frequencies were aortic regurgitation, 8; mitral regurgitation, 22; and mixed, 18. The aortic orifice dimension was significantly different among the regurgitant cases, highest in aortic regurgitation (p = .001). Aortic orifice dimension increased with hypertension duration (p = .028). Conclusions: Regurgitant lesions are common and occur early in hypertensive Africans. Apparently mild valvular regurgitation may accentuate preclinical concentric hypertrophy in hypertensive blacks.
adult; aorta valve regurgitation; arterial wall thickness; artery diameter; article; cardiovascular risk; clinical article; clinical assessment; comparative study; controlled study; disease duration; disease severity; Doppler echocardiography; essential hypertension; female; heart left atrium; heart left ventricle ejection fraction; heart left ventricle enddiastolic volume; heart left ventricle filling; heart rate; heart size; heart volume; human; male; mitral valve regurgitation; Nigeria; priority journal; two dimensional echocardiography; Adult; African Continental Ancestry Group; Aged; Echocardiography, Doppler; Female; Heart Valve Diseases; Heart Ventricles; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Middle Aged; Nigeria; Organ Size; Ventricular Function, Left