186 Impact of pattern of left ventricular geometric adaptation on left ventricular ejection fraction in patients of African ancestry with moderate to severe hypertension Haroon Abbasi, Elena Libhaber, Gavin Norton, Angela Woodiwiss, Karen Sliwa and Rafque Essop Division of Cardiology, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa Introduction: The pathophysiology of left ventricular (LV) remodelling in patients with hypertension (HT) is unclear. Aim: To evaluate the impact of four different types of geometric adaptations to hypertension on left ventricular ejection fraction (LVEF). Methods: A prospective single-centre study of 175 Black African patients (55% female, age = 53.1 ± 10.1 years) with moderate-to-severe HT was performed. HT was defned as systolic or diastolic daytime ambulatory BP (ABPM) >140mmHg or 95mmHg respectively. Echocardio- graphy was performed using a HP 1 500 machine connected to 2.5 MHZ transducer. LV dimensions (LVEDD, LVESD, LVEF) were measured using standard American Society of Echocardiography defnitions. Comparisons between the four geometric patterns were analysed using the Kruskal-Wallis test. Results: Conclusion: Patients with eccentric LVH have the lowest systolic performance as measured by LVEF. These results suggest that patients with eccentric LVH need more aggressive therapy for heart failure. ABSTRACTS SA HEART CONGRESS 2010 Four patterns Age (years) 54.02 ± 9.30 52.25 ± 8.80 51.30 ± 11.62 60.35 ± 13.18 0.075 Gender (f,n,%) 17(38) 20(11) 46(100) 14(100) <0.0001 SBP (din) 163.51 ± 15.07 171.37 ± 21.80 177.21 ± 19.75 172.42 ± 17.61 0.012 DBP (din) 102.44 ± 9.43 105.00 ± 10.49 106.13 ± 9.61 105.35 ±10.59 0.30 SBP (day) 158.77 ± 13.08 166.08 ± 15.39 169.54 ± 19.02 165.35 ± 15.84 0.023 DBP (day) 101.88 ± 7.26 106.64 ± 8.96 106.21 ± 10.69 104.50 ± 8.51 0.023 SBP (24-h) 156.20 ± 12.91 161.57 ± 16.00 165.89 ± 19.80 162.71 ± 16.61 0.059 DBP (24-h) 98.86 ± 7.50 102.62 ± 9.49 103.02 ± 11.25 100.92 ± 8.51 0.08 SBP (din) 163.51 ± 15.07 171.37 ± 21.80 177.21 ± 19.75 172.42 ± 17.61 0.012 DBP (din) 102.44 ± 9.43 105.00 ± 10.49 106.13 ± 9.61 105.35 ±10.59 0.30 LVEDD 5.03 ± 0.60 4.56 ± 0.76 4.41 ± 0.49 5.38 ± 0.53 <0.0001 LVESD 3.55 ± 0.87 3.12 ± 0.78 2.88 ± 0.46 3.80 ± 0.56 <0.0001 EF % 57.12 ± 16.69 59.11 ± 12.59 63.60 ± 8.03 52.35 ± 10.14 0.0075 Normal Concentric Concentric Eccentric LVH P value geometry remodelling LVH