Assessment of left ventricular functions by atrioventricular plane displacement and conventional methods in patients with hypertension and diabetes mellitus

Abstract

The left ventricular systolic and diastolic functions are closely related to mortality and morbidity. Early recognition and appropriate therapy of left ventricular dysfunction is advisable to prevent further progression of heart failure and death. The aim of this study is to estimate the left ventricular functions by AVPD and conventional methods in patients with hypertension (HT) and diabetes mellitus (DM). Eighty nine patients with HT and DM (50 female, 39 male and mean age 54.4±5.2 and 56.3±9.6, respectively) and 65 healthy subjects (34 female, 31 male, and mean ages 51.6±8.5 and 53.8±8.2) underwent complete echocardiographic assessment. There was no difference in ages of the patients and healthy subjects in both gender. The systolic mitral AVPD was recorded at 4 sites (septal, lateral, anterior, and posterior) by M-mode echocardiography and left ventricular ejection fraction was calculated from the AVPD- mean (EFAVPD). Female patients had significantly higher body mass index (BMI) (31.5±4.8kg/m2) than healthy female subjects (27.5±4.3 kg/M2, p<0.001). Left ventricular diastolic dysfunction was shown in patients with HT and DM in both gender. Systolic functions, as assessed by conventional measures in the patients and healthy subjects in both gender were not stastically different significantly and were in normal limits. Both the septal, anterior, lateral and posterior part of the atrioventricular plane values and also AVPD-mean during systole was statistically lower in both gender, in the patients (12.9±1.8 mm in female and 12.9±1.7 mm in male) compared with controls (14.7±2.2 mm in female, p<0.01 and 14.1±1.7 mm in male, p<0.05). EFAVPD of the patients was statistically lower in both gender (65.7±9.7% in female and 65.7±9.5% in male) compared with healthy subjects (75.6±12.1% in female, p<0,01 and 73.0±9.1% in male, p<0.05). As a conclusion, the AVPD method, even if it is in normal limits, might be more sensitive in evaluation of left ventricular function in patients with HT and DM, because of a relatively lower AVPD-mean and EFAVPD in the patients compared with controls. The mitral AVPD is reproducible, widely applicable and a simple non-invasive method for the estimation of left ventricular systolic function in the patients.