P1-07: The use of echocardiography left ventricular filling pressures in hypertensive patients with heart failure and preserved systolic function in an North Africa unit day - 12/02/16
Évaluation par l'échocardiographie des pressions de remplissage chez des patients hypertendus en insuffisance cardiaque à fraction d'éjection préservée en unité d'hôpital de jour
Résumé |
Background |
To assess the left ventricular (LV) filling pressures by Doppler Tissulaire Imaging (DTI), in the management of hypertensive patients with heart failure and preserved systolic function.
Methods |
From 2004 to 2014, heart failure with preserved systolic function (HF-PEF) has been diagnosed in 200 consecutive hypertensive patients (pts) at the outpatient unit.
Data were collected on comorbid conditions including diabetes and atrial fibrillation (AF). A LV ejection fraction > 40% is taken as the including criteria. Diastolic function is assessed by the early diastolic velocity (Em) in the myocardium, the late diastolic velocity (Am), the early diastolic velocity at the mitral valve annulus (Ea) and by comparing time duration of “A mitral wave” (Am) and “A pulmonary wave” (Ap).
Abstract P1-07 – Figure
Abstract P1-07 – Figure
Results |
Mean age was 65±11yrs; 66% were female; waist circumference was abnormal in 82% of the pts and 50% were diabetics. Dyslipidemia is depicted in 78pts (39%). Ischemic heart disease was diagnosed in 64pts (32%); peripheral artery disease (PAD) in 78pts (39%); valvular disease in 20%.
The electrocardiogram (ECG) showed AF in 60pts (30%), complete left bundle branch block (LBBB) in 20pts (10%).
The echographic findings were as follow:
– | Left ventricular hypertrophy (LVH) in 126pts (63%) |
– | Delayed relaxation (Em/Am<1) and deceleration time>150ms (DT) in 80pts (40%), of them, 56 had increased filling pressures (Em/Ea>8 and Ap>Am). |
– | Pseudo normal patterns (1<Em/Am<2 and DT<150ms) in 80 pts (40%). |
– | Restrictive filling pattern (Em /Am more than 2) and short DT<100ms in 40 pts (20%). |
Conclusions |
The hypertensive patients referred for an echo examination are often diabetics and frequently demonstrate preserved left ventricular function with increased filling pressures. This is useful for managing their treatments by an appropriate use of diuretics, angiotensine-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB's) in the context of a cardiac rehabilitation program including learning of target blood pressure, LDL-cholesterol and HbA1c.
Le texte complet de cet article est disponible en PDF.Vol 64 - N° S1
P. S25 - décembre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?