[Changes in left ventricular filling after acute increase of afterload in essential arterial hypertension with or without left ventricular hypertrophy]
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G Antonelli1, M Campaniello, N Di Venere
1Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi, Bari.
Insights
Left ventricular hypertrophy (LVH) in arterial hypertension (AH) is linked to abnormal left ventricular filling (LVF). Doppler echocardiography revealed distinct LVF patterns in hypertensive patients with LVH, suggesting a causal relationship.
Area of Science:
- Cardiology
- Physiology
Background:
- Arterial hypertension (AH) can lead to left ventricular hypertrophy (LVH).
- The relationship between LVH and abnormal left ventricular filling (LVF) in AH requires further clarification.
Purpose of the Study:
- To investigate if LVH in arterial hypertension is associated with specific patterns of left ventricular filling.
- To assess changes in LVF during isometric exercise in hypertensive individuals with and without LVH.
Main Methods:
- Doppler echocardiography was used to examine 30 subjects: 10 hypertensives with LVH, 10 hypertensives without LVH, and 10 normotensives.
- Left ventricular filling (LVF) was analyzed at rest and during isometric handgrip exercise.
Main Results:
- Hypertensive patients with LVH showed significantly higher A wave peak velocity and lower E wave peak velocity at rest compared to normotensives.
- The E/A ratio was significantly lower in both hypertensive groups compared to the normotensive group.
- Transient afterload increase via handgrip exercise revealed altered LVF patterns in hypertensive subjects.
Conclusions:
- Left ventricular hypertrophy in arterial hypertension is associated with abnormal left ventricular filling patterns.
- These findings suggest a potential causal link between LVH and impaired diastolic function in hypertensive individuals.
Abstract:
It is debatable whether a direct causal link exists between left ventricular hypertrophy (LVH) and abnormal left ventricular filling (LVF) in arterial hypertension (AH). To assess if LVH is responsible for peculiar patterns of LVF, we examined 30 selected subjects, similar in age and body surface area, by Doppler echocardiography: 10 hypertensives (SBP: 158 +/- 15; DBP: 105 +/- 7 mmHg) with LVH (IM: 154 +/- 19 mg/m2) (Group 1); 10 hypertensives (SBP: 157 +/- 9; DBP: 101 +/- 5 mmHg) without LVH (IM: 105 +/- 17 mg/m2; Group 2); 10 normotensives without familiar history of AH (Group 3). LVF was analyzed in baseline conditions and during transient afterload increase, obtained by isometric exercise (handgrip, HG, for 5 min at 30% of maximal effort). At rest: 1) A wave peak velocity resulted significantly higher (p less than 0.01) in Group 1 (61 +/- 3 cm/s) versus Group 3 (52 +/- 7 cm/s), and E wave peak velocity was significantly lower in Group 1 (58 +/- 13 cm/s) versus Group 3 (74 +/- 10 cm/s); 2) Group 2 values (E wave: 66 +/- 12; A wave: 58 +/- 15 cm/s) were intermediate between those of groups 1 and 3, and with no significant differences; 3) E/A ratio resulted significantly lower both in Group 1 (1.04 +/- 0.2) and Group 2 (1.21 +/- 0.2) versus Group 3 (1.6 +/- 0.4).(ABSTRACT TRUNCATED AT 250 WORDS)