Abstract
Objective: Left ventricular diastolic dysfunction (LVDD) is a key mechanism in the development of heart failure with preserved ejection fraction (HFpEF), particularly in patients with arterial hypertension. Objective is to assess the features of structural and diastolic remodeling of the left ventricle in patients with AH without concomitant comorbid conditions. Design and method: This prospective, descriptive, single-center study included 146 patients with AH and no cardiovascular diseases or conditions that could affect LV diastolic function. All participants underwent clinical and instrumental evaluation, including transthoracic echocardiography. Parameters assessed included LVEF, LVMI, LAVI, E/A ratio, tissue Doppler indices (e’, E/e’), and tricuspid regurgitation velocity. Results: All patients had normal LVEF. LVDD was identified in 19.2% of participants, more frequently in individuals >60 years. Age-related changes in LV filling were observed: E/A <0.8 was associated with elevated filling pressures and increased LVMI and LAVI. In patients with LV hypertrophy, more pronounced remodeling and impaired diastolic function (higher E/e’, prolonged isovolumetric relaxation) were documented. Patients with grade III hypertension demonstrated the most significant structural changes and pressures. No tricuspid regurgitation velocity >2.8 m/s was recorded. Conclusions: Arterial hypertension without comorbidities is associated with age-dependent changes in LV structure and diastolic function, indicating early manifestations of diastolic dysfunction. Regular echocardiographic monitoring is recommended to ensure timely detection of progressive myocardial remodeling.