[Echocardiographic observations of hypertensive heart disease: a follow-up study].

A comparative echocardiographic study was made in 11 patients with hypertension (at the stage I or II of WHO classification) and ten healthy volunteers to investigate morphologic and functional effects of hypertension on the heart during cumulative 5 years or more. The echocardiographic parameters used in this study were left atrial dimension (LAD), left ventricular diastolic dimension (LVDd), thickness of the interventricular septum (IVS) and the posterior wall of the left ventricle (LVPW), diastolic descent rate of the mitral valve (DDR), left ventricular ejection fraction (EF), mean velocity of circumferential fiber shortening (mVCF), and the ratio of IVS to LVPW (IVS/LVPW). The patients with hypertension showed statistically significant differences from the normal subjects in each parameter, and the following results were obtained: The LAD showed significant increase with time. The increase was present in only 36% of the patients on the initial echograms, but in 91% 5 years later. The LVDs showed no significant chronological changes. The IVS exhibited a tendency to increase early in the course of the disease with subsequently significant changes with time, though its rate of change was low after 5 years of the illness. The LVPW increased in 18% of the patients early in the course of the disease and in 100% after 5 years of the initial study. This rate of change was greater than that of the IVS. The mVCF, DDR and EF also diminished to a significant extent. Values of IVS/LVPW indicated that the left ventricle initially is apt to have asymmetric hypertrophy and then symmetric hypertrophy. These results indicate that in the presence of hypertension the heart initially shows asymmetric hypertrophy with a prominent thickening of the IVS, and then, with the persistence of the disease, the hypertrophy of the LVPW becomes marked, resulting in symmetric hypertrophy of the heart. These morphologic changes in turn are attended by a significant reduction of functional parameters including EF, DDR and mVCF.