ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT VENTRICULAR EJECTION FRACTION IN HYPERTENSIVE AND DIABETIC PATIENTS WITH LEFT VENTRICULAR HYPERTROPHY

Abstract

Background: Hypertension and type 2 diabetes mellitus are major risk factors for cardiovascular disease and frequently lead to left ventricular hypertrophy (LVH). Persistent pressure overload and metabolic abnormalities may impair left ventricular systolic function, making assessment of left ventricular ejection fraction (LVEF) essential for early detection of cardiac dysfunction. Echocardiography is the preferred non-invasive modality for evaluating LVEF and LVH in these patients. Objective: To assess left ventricular ejection fraction using echocardiography in hypertensive and diabetic patients with left ventricular hypertrophy and determine its association with demographic and clinical characteristics. Methods: A retrospective cross-sectional analytical study was conducted at Rehman Medical Institute (RMI), Peshawar, over a period of six months. A total of 90 adult patients with hypertension, type 2 diabetes mellitus, and echocardiographically confirmed LVH were included using consecutive sampling. Demographic and clinical data were obtained from hospital records. Transthoracic echocardiography was used to evaluate LVEF and classify LVH. Data were analyzed using SPSS version 26. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Chi-square test, independent t-test, and ANOVA were used where appropriate, with a p-value <0.05 considered statistically significant. Results: The mean age of participants was 59.01 ± 14.12 years, and 51.1% were male. Hypertension was present in 85.6% of patients, while 91.1% had diabetes mellitus. Concentric hypertrophy was the most common LVH pattern (45.6%), followed by eccentric hypertrophy (30.0%) and concentric remodeling (24.4%). Mildly impaired LVEF was the most frequent finding (31.1%). A statistically significant association was observed between hypertension and LVEF (χ² = 14.145, p = 0.003). However, no significant associations were found between LVEF and diabetes mellitus (p = 0.614), LVH type (p = 0.550), gender (p = 0.085), or age (p = 0.194). Conclusion: Hypertension was significantly associated with reduced left ventricular ejection fraction in patients with left ventricular hypertrophy, whereas diabetes mellitus, age, gender, and LVH geometry showed no significant association. Routine echocardiographic assessment of LVEF in hypertensive patients with LVH may facilitate early detection of systolic dysfunction and improve clinical management.

Keywords: Left ventricular ejection fraction, echocardiography, hypertension, diabetes mellitus, left ventricular hypertrophy, systolic function.