Diastolic filling abnormalities in children with essential hypertension.

Abstract

To evaluate whether essential hypertension impacts diastolic function in children. In this cross-sectional study, patients with essential hypertension (n = 50) were compared with a normotensive group (n = 53). Echocardiographic assessment of diastolic function included measures derived from transmitral, color M-mode, and tissue Doppler interrogation. Cardiac dimensions, wall thickness, geometry, and systolic function were also assessed. Multiple linear regression analysis was performed to identify predictors of altered diastolic function. Diastolic filling abnormalities were found in 36% of the children with blood pressure elevation. Those subjects with concentric hypertrophy were more significantly affected. Abnormalities in indices reflective of left ventricular (LV) relaxation occurred more commonly (39%) than those of LV compliance (33%). Elevated indexed LV mass was found to be the most significant independent predictor of diastolic filling abnormalities. LV diastolic filling abnormalities were found in one-third of the pediatric subjects with essential hypertension. Whether these changes represent an adaptive or maladaptive response requires further study.