Clinical Update: Dysfunction difficult to reverse

HYPERTENSION: Even in early hypertension, diastolic dysfunction in the left ventricle is very difficult to reverse. Almost half of people with hypertension have diastolic dysfunction.

Blood pressure lowering is very important but if the doctor does not measure the echocardiographic parameters, he or she will not know if patients already have changes in the heart.

Echocardiographs are very important as they enable effective intervention, said Dr Azra Mahmud, TCD Lecturer in Pharmacology and Therapeutics. Another parameter which is prognostic in hypertension is concentric remodeling. The heart is not enlarged overall but the wall is remodeled. This is a very early indicator for hypertension.

Once men consume more than 21 units of alcohol per week, there is an increased likelihood of concentric remodeling and diastolic dysfunction. The wall of the left ventricle becomes much thicker, compared to the lumen.

The cells de-align themselves to be able to sustain a huge amount of pressure coming back to the heart. There won’t be any LVH on the echo. The smooth muscle cells hypertrophy. It seems the diastolic function and the way the heart contracts could differ between somebody who has physiological or pathological LVH. – Irish Medical Times