Association of Left Ventricular Hypertrophy with the Extent of Coronary Artery Disease in Hypertensive Patients

Abstract

Background Left ventricular hypertrophy (LVH) is a risk factor for cardiac and vascular events in hypertensive patients (pts). The aim of the study was to evaluate the associaton of echocardiographic indices of LV geometry with the extent of coronary artery disease (CAD) in hypertensive patients catheterized on the basis of symptoms of angina.
Methods Study group included 197 pts, age 53 ± 9 years, 65 women, without significant valvular disease and history of myocardial infarction. LV diastolic diameter (LVD), intraventricular septum (IVS) and posterior wall (PW) thickness were evaluated with M-mode echocardiography. Coronary artery disease extent was assessed with Gensini score (GS).
Results In univariate analysis age was not correlated with any of LV geometry indices. Body surface area (BSA) was correlated with LVD (r = 0.33, p < 0.0001), PW (r = 0.46, p < 0.0001), IVS (r = 0.40, p < 0.0001). Both duration of hypertension and GS were correlated with IVS (r = 0.18, p < 0.05 and r = 0.23, p < 0.001) and PW (r = 0.20, p < 0.01 and r = 0.23, p < 0.001 ) but not with LVD. Stepwise multiple regression has shown that LVD was dependent only on BSA (ß = 0.25, p < 0.01) (R = 0,37). PW was dependent on BSA ((ß = 0.39, p < 0.0001), hypertension grade (ß = 0.24, p < 0,0001) and GS (ß = 0.16, p < 0.05)(R = 0.57). Similarly IVS was related to BSA (ß = 0.34, p < 0.001), hypertension grade (ß = 0.23, p < 0.01) and GS (ß = 0.16, p < 0.05) (R= 0.57).
Conclusion The study revealed independent association between left ventricular septum and free wall thickness and the extent of atherosclerotic coronary artery disease in hypertensive patients with angina. That should be further elucidated.