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Published on: December 11, 2017

Ventricular and myocardial function following treatment of hypertension

G P Aurigemma1, D Williams, W H Gaasch

  • 1Division of Cardiology, University of Massachusetts Medical School, Worcester, USA. aurigemg@ummhc.org

The American Journal of Cardiology
|March 16, 2001
PubMed

Insights

Antihypertensive therapy does not impair left ventricular (LV) function. Improvements in midwall shortening are linked to normalized LV geometry, not just reduced LV mass.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Cardiac Physiology

Background:

  • Hypertension often leads to left ventricular (LV) remodeling and dysfunction.
  • Previous studies on hypertension treatment focused on overall cardiac function, neglecting detailed myocardial mechanics.
  • LV midwall mechanics provide a more direct assessment of myocardial function than endocardial measures.

Purpose of the Study:

  • To evaluate left ventricular (LV) contractile function, specifically midwall mechanics, following hypertension treatment.
  • To analyze the relationship between changes in LV mass, geometry, and myocardial function after antihypertensive therapy.

Main Methods:

  • Assessed LV contractile function using endocardial fractional shortening and LV midwall shortening in 268 hypertensive patients.
  • Related shortening indices to end-systolic circumferential stress, considering changes in LV mass and relative wall thickness.
  • Followed patients for 1-2 years to observe changes after antihypertensive treatment.

Main Results:

  • No significant changes in overall endocardial or midwall shortening were observed in the entire patient group.
  • A subgroup of 83 patients showed reduced relative wall thickness and improved midwall shortening.
  • Improvements in midwall shortening were significantly correlated with changes in relative wall thickness (r = -0.53, p = 0.0001).

Conclusions:

  • Antihypertensive therapy, in general, does not decrease LV chamber or myocardial function.
  • Enhanced midwall shortening is more associated with the normalization of LV geometry than with the reduction of LV mass.
  • LV midwall mechanics offer valuable insights into myocardial adaptation during hypertension treatment.

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