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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Published on: April 8, 2013

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Midwall mechanics are improved after regression of hypertensive left ventricular hypertrophy and normalization of

S Perlini1, M L Muiesan, C Cuspidi

  • 1Clinica Medica I,IRCCS San Matteo, Università di Pavia, Pavia, Italy. sperlini@unipv.it

Circulation
|February 7, 2001
PubMed

Insights

Regression of hypertensive left ventricular hypertrophy (LVH) improves heart function, with geometric normalization playing a key role. This improvement in myocardial function persists even after blood pressure increases again.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Echocardiography

Background:

  • Hypertensive left ventricular hypertrophy (LVH) is common, but its impact on left ventricular (LV) myocardial function after regression is not fully understood.
  • The relationship between LVH regression, normalization of cardiac geometry, and myocardial function requires further investigation.

Purpose of the Study:

  • To investigate whether substantial regression of hypertensive LVH and normalization of LV geometry are linked to improved LV myocardial function.
  • To determine the relative contributions of reduced LV systolic stress and normalized LV geometry to improved midwall function.

Main Methods:

  • 152 patients with hypertensive LVH underwent 1 year of antihypertensive treatment (lisinopril +/- hydrochlorothiazide).
  • Echocardiography assessed LV mass, relative wall thickness, and midwall fractional shortening before, during, and after treatment.
  • 24-hour ambulatory blood pressure monitoring evaluated blood pressure and calculated end-systolic wall stress.

Main Results:

  • Antihypertensive treatment significantly reduced blood pressure, end-systolic wall stress, and LV mass index.
  • LVH regression was associated with increased midwall fractional shortening and decreased relative wall thickness.
  • Improved midwall function persisted after treatment withdrawal, linked to preserved relative wall thickness despite increased wall stress.

Conclusions:

  • Regression of concentric LVH is associated with improved midwall systolic function.
  • Normalization of LV geometry, rather than solely the reduction in LV systolic stress, is the primary driver of improved systolic function.
Abstract

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