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Effects of long-term blood pressure control on left and right ventricular structure and function in hypertensive
C Cuspidi1, L Sampieri, L Angioni
1Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
Insights
Antihypertensive therapy significantly improves cardiac structure and function in patients with left ventricular hypertrophy (LVH). Both left and right ventricles showed reduced mass and improved diastolic filling after treatment.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Hypertension Research
Background:
- Hypertension frequently leads to left ventricular hypertrophy (LVH).
- Right ventricular (RV) abnormalities can coexist with LVH in hypertensive patients.
- The impact of antihypertensive therapy on RV structure and function in LVH is not fully understood.
Purpose of the Study:
- To evaluate the effects of chronic antihypertensive treatment on both left and right ventricular function and structure.
- To assess changes in ventricular mass, thickness, and diastolic filling patterns.
Main Methods:
- Prospective study involving 10 hypertensive patients with LVH.
- Echocardiography and Doppler assessments performed before and after 1 year of treatment.
- Treatment regimens included captopril alone or in combination with nifedipine.
Main Results:
- Significant reduction in left ventricular mass index and right ventricular wall thickness observed in all patients.
- Significant improvement in Doppler-derived diastolic filling indexes for both ventricles.
- Therapeutic benefits extended beyond the left ventricle to the right ventricle.
Conclusions:
- Chronic antihypertensive therapy effectively reverses anatomical and functional changes in hypertensive patients with LVH.
- The beneficial effects of treatment encompass both the left and right ventricles.
- This suggests a comprehensive improvement in cardiac health with standard antihypertensive regimens.
Abstract:
The functional and anatomical abnormalities of the right ventricle may occur in hypertensive patients with left ventricular hypertrophy (LVH). The present study was designed to assess the functional and structural changes in both left and right ventricles induced by chronic antihypertensive therapy. Doppler and standard echocardiography were performed in 10 hypertensive patients with LVH before and after 1 year of treatment with captopril alone (5 patients) or captopril plus nifedipine (5 patients). We found that the left ventricular mass index and right ventricular thickness were significantly reduced in all patients when compared with pretreatment values. Furthermore, the Doppler-derived diastolic filling indexes show a significant improvement of both ventricular chambers. Our data suggest that anatomical and functional changes induced by therapy in hypertensive patients are not limited to the left ventricle but also involve the right ventricle.