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Relation between cardiac sympathetic activity and hypertensive left ventricular hypertrophy

Markus P Schlaich1, David M Kaye, Elisabeth Lambert

  • 1Human Neurotransmitter Laboratory, Baker Heart Research Institute and Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria 8008, Australia. markus.schlaich@baker.edu.au

Circulation
|July 9, 2003
PubMed

Insights

Hypertension-induced left ventricular hypertrophy is linked to heightened cardiac sympathetic activity. This suggests increased norepinephrine release in the heart contributes to the development of left ventricular hypertrophy.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Autonomic Nervous System Studies

Background:

  • Left ventricular (LV) hypertrophy is a significant risk factor for cardiovascular events in hypertensive individuals.
  • The role of sympathetic activation in the development of LV hypertrophy in humans requires further validation.

Purpose of the Study:

  • To investigate and compare systemic and regional sympathetic activity in hypertensive patients with and without left ventricular hypertrophy.
  • To determine the relationship between sympathetic activity and left ventricular mass in hypertension.

Main Methods:

  • Utilized radiotracer dilution methods and microneurography to assess sympathetic activity.
  • Compared three groups: hypertensive with LV hypertrophy (EH+), hypertensive without LV hypertrophy (EH-), and normotensive controls (NT).
  • Measured LV mass index, total body and renal norepinephrine spillover, muscle sympathetic nerve activity, and cardiac norepinephrine spillover.

Main Results:

  • Muscle sympathetic nerve activity and cardiac norepinephrine spillover were significantly elevated only in the hypertensive group with LV hypertrophy (EH+).
  • Cardiac norepinephrine spillover showed a positive correlation with LV mass index across all subjects.
  • While total body and renal norepinephrine spillover were higher in both hypertensive groups, cardiac-specific activity was uniquely increased in EH+.

Conclusions:

  • Hypertensive left ventricular hypertrophy is associated with sympathetic activity predominantly localized to the heart.
  • Increased cardiac norepinephrine release appears to be a key factor in the development of left ventricular hypertrophy in hypertensive patients.
Abstract

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