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Myocardial cell damage in human hypertension
G Pons-Lladó1, M Ballester, X Borrás
1Servei de Cardiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. gponsl@meditex.es
Insights
Hypertension can cause myocardial cell damage, particularly in patients with left ventricular hypertrophy (LVH). This study shows that the severity of this damage correlates with the degree of LVH in hypertensive individuals.
Area of Science:
- Cardiology
- Medical Imaging
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) in hypertensive patients, though initially compensatory, can lead to myocellular damage and heart failure.
- Noninvasive methods for detecting myocardial damage are crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate myocardial cell damage in patients with systemic hypertension.
- To determine the relationship between myocardial damage and left ventricular hypertrophy (LVH) in these patients.
Main Methods:
- Utilized 111In-labeled monoclonal antimyosin antibodies for imaging myocardial damage in 39 hypertensive patients.
- Categorized patients into three groups based on LVH severity and symptoms.
- Quantified myocardial damage using heart-to-lung antibody uptake ratios.
Main Results:
- Abnormal antimyosin scans, indicative of myocardial damage, were found in 25% of patients with normal left ventricular mass (LVM), 16% with LVH, and 100% with advanced LVH and symptomatic disease.
- A significant correlation (p < 0.001) was observed between the degree of myocardial damage and the magnitude of LVH.
- Multivariate analysis identified LVM index as the primary independent predictor of myocardial antimyosin uptake (r = 0.815; p = 0.001).
Conclusions:
- This study presents the first in vivo evidence of myocyte damage in hypertensive patients.
- The extent of myocardial damage is directly related to the severity of left ventricular hypertrophy.
Objectives:
The goal of this study was to investigate the presence of myocardial cell damage in patients with systemic hypertension and its relationship with left ventricular hypertrophy (LVH).
Background:
Although initially compensatory, LVH adversely affects myocellular integrity and contributes to congestive heart failure in hypertensive patients. Noninvasive detection of myocardial damage can be of value.
Methods:
We performed imaging studies with 111In-labeled monoclonal antimyosin antibodies to identify myocardial damage in 39 patients with systemic hypertension and variable degrees of LVH. Three groups were considered: 16 asymptomatic patients with normal echocardiographic left ventricular mass (LVM) (group I); 14 asymptomatic patients with LVH (group II) and 9 patients with symptomatic hypertensive heart disease and advanced LVH (group III). The severity of myocardial damage was represented as heart-to-lung (target-to-background) antibody uptake ratio (normal: <1.55).
Results:
Mean LVM index was 105+/-14 g/m2 in group I, 124+/-24 in group II and 174+/-29 in group III. Heart-to-lung ratios of antimyosin uptake were: 1.45+/-0.14 in group I, 4 of the 16 (25%) patients showing an abnormal scan; 1.50+/-0.07 in group II with abnormal scans in 2 of the 14 (16%) patients and 1.77+/-0.16 (p < 0.001) in group III, all 9 patients presenting with abnormal antimyosin scans. On multivariate regression analysis LVM index was the main variable that independently correlated with the degree of myocardial uptake of antimyosin (r = 0.815; p = 0.001).
Conclusions:
This study provides the first in vivo evidence of myocyte damage in patients with hypertension. The severity of myocardial damage can be related to the magnitude of LVH.