INAPPROPRIATE LEFT VENTRICULAR MASS IN HYPERTENSIVE ADOLESCENTS

Objective: Inappropriate left ventricular mass (ILVM) is an entity where the observed left ventricular mass (LVM) exceeds the theoretically expected. This condition increases cardiovascular risk in adults; however, there are no data in adolescents. We evaluated the relationship between the ILVM and ambulatory arterial pressure’s parameters and the left ventricular function on teenagers. Design and method: This was a cross-sectional study conducted with 410 high school students (205 males and 205 females), aged between 13 to 18 years (mean= 15.10 ± 1.53 years). In all patients, anthropometric data and office blood pressure were measured. They were studied by 24-hour ambulatory blood pressure monitoring and Doppler echocardiography and divided into two groups on the basis of LVM appropriateness. ILVM in adolescents was defined according to De Simone at col. Finally, subjects were classified according to blood pressure phenotype for the analyses. Results: ILVM was present in 111 adolescents (27.1%), more frequently in males than in females (42.4% vs. 11.7%, p<0.001). Patients with ILVM presented significantly higher casual systolic blood pressure and pulse pressure; 24-hour systolic blood pressure and ambulatory pulse pressure during the day and night. 42.4% of casual hypertensive patients (HT) and 25.7% of non-HT showed ILVM (RR = 2.127 - 95% CI (1.027-4.405); p<0.05). When considering the blood pressure phenotypes, it was observed that the prevalence of ILVM was higher in the sustained hypertensive group than in the rest of the groups (47.8%; p = 0.024). In the analysis of the echocardiographic data, the patients with ILVM presented lower ejection fraction (67.7% ± 7.45 vs. 69.5% ± 6.55; p = 0.019), longer deceleration time (270.96 ms ± 85.66 vs. 247.28 ms ± 80.73; p = 0.010) and left atrial diameter (3.44 cm ± 0.38 vs. 3.07 cm ± 0.36; p < 0.001). Conclusions: Inappropriate left ventricular mass is a prevalent condition in adolescents, it is more frequent in males with sustained hypertension and reflects incipient changes in ventricular function; its impact in adulthood remains to be evaluated.