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Left ventricular adaptation to hypertension and plasma renin activity
G du Cailar1, J L Pasquié, J Ribstein
1Service de Médecine Interne G, Hopital Lapeyronie, 34295 Montpelier Cedex 5, France.
Journal of Human Hypertension
|March 1, 2000
Summary
In essential hypertension, left ventricular hypertrophy patterns are linked to distinct hemodynamic profiles and renin-angiotensin system activity. Eccentric hypertrophy correlates with higher cardiac index and lower plasma renin activity.
Area of Science:
- Cardiology
- Hypertension Research
- Renal Physiology
Background:
- Chronic pressure and volume overload cause distinct myocardial hypertrophy.
- The impact of these factors on left ventricular morphology in essential hypertension is not fully understood.
Purpose of the Study:
- To investigate the association between renin-angiotensin system activity and left ventricular adaptation in never-treated hypertensive patients.
- To explore how different left ventricular hypertrophy patterns relate to hemodynamic and functional profiles.
Main Methods:
- Echocardiography was used to categorize 333 never-treated hypertensive patients based on left ventricular mass and relative wall thickness.
- Plasma renin activity was measured to assess the renin-angiotensin system.
- Hemodynamic parameters and myocardial contractility were evaluated.
Main Results:
- Higher systolic and pulse arterial pressure were linked to concentric left ventricular hypertrophy.
- Eccentric left ventricular hypertrophy was associated with a higher cardiac index and lower basal plasma renin activity.
- Concentric left ventricular hypertrophy showed a tendency for depressed myocardial contractility.
Conclusions:
- In early essential hypertension without renal dysfunction, distinct anatomical patterns of cardiac adaptation correlate with specific hemodynamic, myocardial function, and renin-angiotensin system activity profiles.
- These findings highlight the heterogeneous nature of left ventricular remodeling in hypertension.