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Relation of circulating blood volume to left ventricular geometry in essential hypertension
Kotaro Yasumoto1, Masanobu Takata, Hitoshi Ueno
1Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Insights
In hypertension, reduced blood volume may cause a smaller left ventricle (LV) chamber (concentric remodeling). However, enlarged LV chambers (eccentric hypertrophy) are not linked to blood volume in mild to moderate cases.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Investigation
Background:
- Essential hypertension is a common condition affecting cardiovascular health.
- Left ventricular (LV) geometry can be altered in hypertensive patients.
- The role of circulating blood volume in LV geometry changes requires further investigation.
Purpose of the Study:
- To determine if circulating blood volume influences left ventricular (LV) geometry in patients with essential hypertension.
- To explore the relationship between plasma and blood volumes and different patterns of LV geometry.
Main Methods:
- Echocardiography was used to classify LV geometry into four patterns: normal, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy.
- Plasma volume and blood volume were measured using the 131I labeled human serum albumin technique.
- Study included 60 outpatients with untreated, mild to moderate essential hypertension and 45 normotensive controls.
Main Results:
- LV end-diastolic volume was significantly greater in the eccentric hypertrophy group compared to other groups.
- Plasma volume and blood volume were decreased in the concentric remodeling group versus other groups.
- No significant differences in plasma or blood volume were observed among normal LV, eccentric hypertrophy, and concentric hypertrophy groups.
Conclusions:
- Decreased plasma and blood volumes may be associated with a smaller LV chamber in concentric remodeling.
- Enlarged LV chambers in eccentric hypertrophy are unlikely to be related to plasma or blood volume levels in mild to moderate essential hypertension.
Abstract:
To investigate whether circulating blood volume contributes to left ventricular (LV) geometry, 60 outpatients with untreated, mild to moderate essential hypertension and 45 normotensives were studied. Based on echocardiographic LV mass index and relative wall thickness, four patterns of LV geometry, i.e., normal left ventricle, concentric remodeling, eccentric hypertrophy and concentric hypertrophy, were identified. Plasma volume and blood volume were measured by the 131I labeled human serum albumin technique. LV end-diastolic volume was greater in patients with eccentric hypertrophy than in the groups of patients with normal left ventricles, concentric remodeling, or concentric hypertrophy or in normotensive subjects. No differences were found in systolic function among the five groups. Both plasma volume and blood volume were decreased in the concentric remodeling group as compared with the other four groups. However, there were no differences in plasma volume or blood volume among the normal left ventricle, eccentric hypertrophy and concentric hypertrophy groups. These data indicate that a small LV chamber in cases of "concentric remodeling" may be related to decreased plasma and blood volumes, but an enlarged LV chamber in cases of "eccentric hypertrophy" is not likely to be related to either plasma or blood volume levels in mild to moderate untreated essential hypertension.