ECHOCARDIOGRAPHIC STUDY IN CHILDREN WITH BORDERLINE OR ESSENTIAL MILD-TO-MODERATE SYSTEMIC HYPERTENSION

The purpose of this study was to assess anatomic and functional response of left ventricle in very young children (6 months to 3 years of age) with bordeline or mild-to-moderate systemic hypertension. Twelve hypertensive patients were evaluated with electrocardiograms and with M-mode and two dimensional Echocardiograms and compared to twenty-two normotesive control subjects matched by sex, age and body surface area. No subject in the two groups demonstrated electrocardiographic evidence of left ventricular hypertrophy or signs of left atrial enlargement. Average values of the following parameters (all within normal range for age and body surface) were however statistically significantly higher in the hypertensive group than in the matched subjects: 1) interventricular septum thickness (7.50 +/- 1.10 vs 6.20 +/- 0.60 mm; p < 0.001); 2) left ventricular mass (129.43 +/- 39.70 vs 81.20 +/- 18.30 g/m2; p < 0.001); 3) left ventricular dimension at end-diastole (32.80 +/- 3.70 vs 28.10 +/- 3.40 mm; p < 0.001). No significant difference was observed in the two groups concerning left ventricular function indexes. Our conclusions suggest that there is no marked early involvement of the heart in young children with bordeline or mild-to-moderate essential hypertension. However some heart parameters were in the high limits of normal ranges suggesting a trend to ventricular hypertrophy. The study needs further investigation in order to demonstrate positive correlation between duration and severity of the hypertensive status and development of left ventricular hypertrophy.