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Left ventricular filling in the hypertensive patient: long-term course and influence of treatment
Insights
Antihypertensive treatment did not prevent long-term decline in left ventricular filling (E/A ratio) in hypertensive patients. Blood pressure and left ventricular mass reductions were observed, but filling abnormalities persisted.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Hypertension is linked to left ventricular filling abnormalities.
- The impact of antihypertensive treatment on these abnormalities is not fully understood.
Purpose of the Study:
- To assess the long-term progression of left ventricular filling abnormalities in hypertensive patients.
- To compare the course of these abnormalities in treated versus untreated patients.
Main Methods:
- Retrospective study of 73 hypertensive patients followed for at least 3 years.
- Left ventricular filling assessed via pulsed Doppler echocardiography of mitral flow.
- Patients divided into untreated (Group 1) and treated (Group 2) groups.
Main Results:
- In untreated patients, no significant changes in blood pressure or left ventricular mass were noted; mitral flow E/A ratio showed a nonsignificant decrease.
- Treated patients experienced a reduction in heart rate-adjusted E/A ratio, alongside decreased blood pressure and left ventricular mass.
- Age and heart rate were the primary correlates of mitral flow in the overall population.
Conclusions:
- Antihypertensive therapy did not halt the long-term decrease in the E/A ratio in hypertensive individuals.
- Despite improvements in blood pressure and left ventricular mass, filling abnormalities persisted with treatment.
Background:
Hypertension is accompanied by abnormalities in left ventricular filling; however, there is a lack of agreement on the extent of the influence of antihypertensive treatment on them.
Hypothesis:
The present study was designed to evaluate the long-term course of these abnormalities in both treated and untreated hypertensive patients.
Methods:
Left ventricular filling assessed by pulsed Doppler echocardiography of mitral flow was studied over a long follow-up period in both untreated and treated hypertensive patients. This retrospective study included 73 hypertensive patients who had not received any treatment. They had been followed up for at least 3 years and were divided a posteriori into two groups: Group 1 comprised the untreated patients, while Group 2 included the patients who had received antihypertensive treatment throughout the follow-up period.
Results:
In the overall population, age and heart rate measured during the Doppler examination were the only parameters that correlated significantly with mitral flow. No significant changes in blood pressure or left ventricular mass were observed in Group 1 (14 patients) over the study period. There was a slight but nonsignificant decrease in E/A ratio of mitral flow. In the treated patients, there was a drop in heart rate-adjusted E/A ratio, despite a reduction in blood pressure and left ventricular mass, at mean follow-up of 5 years.
Conclusion:
Antihypertensive therapy did not arrest the long-term reduction in E/A ratio in hypertensive patients despite reduction in blood pressure and left ventricular mass.
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