A023: Left ventricular function in hypertension and athlete's heart: Evaluation by ultrasonic automatic border detection

Abstract

Automatic Border Detection (ABD) allows the real-time measurements of the areas of the cardiac chambers during the cycle, differentiating ultrasonic backscatter characteristics of the blood by those of the myocardium, in a R.O.I. placed by the operator. Some studies with equilibrium radioisothopic ventriculography have showed that in the hypertensive cardiopathy are present abnormalities of diastolic filling: both the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). We have studied three groups of 10 subjects, all males of mean age (31.6 ± 3.5), with comparable weight and height: athlete's group (A) (all cyclists); hypertensive group (I) and control group (C). Hypertensives are selected on the basis of ambulatory blood pressure monitoring results, according to ISH-WHO guidelines. All subjects have performed 2D-color Doppler echocardiography with a digital echograph HP Sonos 5500, for the conventional analysis of left ventricular mass and function. With ABD we have analyzed in real-time both end-diastolic (EDV) and end-systolic volumes (ESV) and the relative ejection fraction (EF); we have obtained, by the study of dV/dt of the volumetric curve, the following parameters: Peak Filling Rate (PER), Time to Peak Filling Rate (TPFR) and the Peak Ejection Rate (PER). Left ventricular mass is comparable between the A and I groups and significantly higher in comparison with group C (LVMbs: A: 154.5 ± 18.7; I: 146.8 ± 25.5; C: 101.4 ± 12.4; p < 0.001). Athlete's heart and hypertensive cardiopathy are different for the following parameters: EDV is significantly higher in athletes (140.5 ± 20.4 ml) in comparison with hypertensives (116.1 ± 17.3 ml) and controls (102.0 ± 15.5 ml) (p < 0.01). PFR is significantly lower in hypertensives (3.07 ± 0.28) in comparison with athletes (3.92 ± 0.29) and controls (3.83 ± 0.33) (p < 0.03). TPFR is significantly higher in hypertensives (146.1 ± 14.6) in comparison with athletes (109.7 ± 16.7) and controls (103.2 ± 16.7) (p < 0.05). ABD allows the differentiation between the two models of left ventricular hypertrophy; the athlete's heart doesn’t show any difference with control group, while hypertensive cardiopathy shows early abnormalities of the left ventricular diastolic filling.

Automatic Border Detection, left ventricular hypertrophy, hypertension, athlete's heart