[The morphofunctional characteristics of cardiac involvement in arterial hypertension in children].

UNLABELLED: The aim of the study was to investigate the main morphofunctional aspects of the cardiac involvement in systemic hypertension in child.

METHODS

48 children with aged ranging between 2 months-18 years, diagnosed with systemic hypertension (SH), were followed up more than 1 year (with treatment) and investigated by clinical examination and noninvasive methods. The etiology of SH was: * secondary SH (40 cases): acute (8) and chronic nephropathy (20), 13 cases being dialysed; coarctation of aorta (10) and pheochromocytoma (2 cases) and * essential SH (8 cases): "borderline" type and also confirmed.

RESULTS

The echocardiographic findings had a superior sensibility to ECG and chest X-ray findings, concerning cardiac involvement in SH, especially in the secondary forms, with high values of systolic and/or diastolic blood pressure and with a long period of evolution: hypertrophy of the left ventricle (LV) (31 cases = 65%) with septal predominance (10); * alteration of diastolic function of LV (11), but with normal systolic function of LV (all the cases). These changes have not been observed in acute nephropathy or they were unsignificant in essential SH. Repeated echocardiography after minimum 6 months proved a varied regression of hypertrophy of LV and improved diastolic function of LV in children who received antihypertensive therapy, including spironolactone and/or angiotensin converting enzyme inhibitors.

CONCLUSION

Because such cardiac involvement are important and of greater risk factor for the hypertensive patients, the early diagnosis by echocardiography, the follow up of the evolution and the diminish of cardiac disorders by the treatment mentioned above, may improve the prognosis of the disease.