198 IS MYOCARDIAL HYPERTROPHY IN HYPERTENSIVE CHILDREN RELATED TO BLOOD PRESSURE?

Abstract

The mechanism for the increase in left ventricular mass (LVM) in children with labile hypertension (HT) remains unresolved. M-mode echocardiograms (ME) were obtained from 27 HT children (mean age 14.4 y) and 26 normotensive (NT) children (mean age 14.1 y) of comparable sex, race and BSA. Mean systolic/diastolic blood pressure (SBP/DBP) in HT was 137/89; that in NT was 110/68 (p < 0.001). ME was digitized/analyzed with H-P computer, and the observed values expressed as SD from predicted normal (σ PN) based on age, BSA and HR. HT and NT values were similar for: LVEDD, LVEDD, LA_max, LVSV, Qlv, LVET and PEP/ET. However, HT values were greater than NT for: wall thickness (p < .001), LVM (p < .005), thickness/radius ratio (t/r) (p < .001), Ao (p < .05) and PEP (p < .025). HT values were lower than NT for %MAS (p < .01) and VCF (p < .05). Poor correlation was observed between SBP or DBP and LVM/M² or O LVM (r = 0.34 to 0.43). Density function curves derived by multi-regression analysis (using equation: Y_dv = K₁ σPN₁ + K₂ σPN₂ + K_n σPN_n ± X, where Y_dv = discriminating value and K, X = constants) and utilizing 11 echo parameters separated HT from NT with minimal overlap (p < .001). Moreover, positive correlation was observed between Y_dv and resting DBP (r = 0.65), suggesting that the cardiac status of HT children may very well be related to the increased pressure overload of labile character and varying duration.

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