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Arterioventricular coupling and ventricular efficiency after antihypertensive therapy: a noninvasive prospective
Martin Osranek1, John H Eisenach, Bijoy K Khandheria
1Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. osranek.martin@mayo.edu
Hypertension (Dallas, Tex. : 1979)
|December 26, 2007
Summary
Antihypertensive therapy improves arterioventricular coupling in hypertension patients by optimizing ventricular mechanical efficiency. This blood pressure normalization enhances cardiac function before changes in ventricular geometry.
Area of Science:
- Cardiology
- Physiology
Background:
- Hypertension impairs the energetic coupling between the ventricle and arterial system.
- This impairment reduces cardiac mechanical efficiency and exercise capacity.
Purpose of the Study:
- To investigate if blood pressure normalization via antihypertensive therapy can improve arterioventricular coupling in hypertensive patients.
Main Methods:
- Eighteen hypertensive patients underwent assessments before and after antihypertensive therapy.
- Transthoracic echocardiography and radial artery applanation tonometry were used.
- Calculations included ventricular elastance, effective arterial elastance, arterioventricular coupling, and mechanical efficiency.
Main Results:
- Antihypertensive therapy significantly reduced systolic and diastolic blood pressure.
- Ventricular elastance increased, while effective arterial elastance decreased, leading to improved arterioventricular coupling.
- Mechanical efficiency significantly improved at rest and during handgrip exercise.
Conclusions:
- Blood pressure reduction in hypertensive patients optimizes arterioventricular coupling towards ventricular mechanical efficiency.
- This shift occurs prior to significant changes in ventricular geometry and may explain early clinical improvements.
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