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[Changes in left ventricular function in elderly hypertension patients]
Insights
Essential hypertension (EH) impairs left ventricular systolic function and relaxation, particularly in elderly patients. Compensatory mechanisms in EH patients are preserved until left ventricular mass exceeds 170 g/m2, after which cardiac output declines.
Area of Science:
- Cardiology
- Internal Medicine
- Physiology
Background:
- Essential hypertension (EH) is a prevalent cardiovascular condition.
- Age-related changes can affect cardiac function in hypertensive individuals.
- Understanding left ventricular (LV) function in elderly hypertensive patients is crucial for management.
Purpose of the Study:
- To investigate systolic function and diastolic filling in elderly patients with stage-II essential hypertension.
- To assess the compensatory role of the left atrium and left ventricle in elderly EH patients.
- To determine the threshold of left ventricular mass index associated with preserved cardiac output.
Main Methods:
- Echocardiographic assessment of 81 stage-II essential hypertension patients and 20 healthy controls.
- Evaluation of left ventricular systolic function, including contractility and relaxation velocity.
- Analysis of left ventricular diastolic filling patterns and atrial contribution.
Main Results:
- EH patients exhibited impaired LV systolic function, with reduced contractility in early systole.
- Altered LV filling patterns were observed, including decreased rapid filling and increased slow filling/atrial contribution.
- Elderly EH patients showed reduced compensatory role of the left atrium and less pronounced LV hypertrophy compared to younger patients.
- Compensatory LV function was maintained up to a LV mass index of 170 g/m2, beyond which cardiac output decreased.
Conclusions:
- Stage-II essential hypertension significantly impacts LV systolic and diastolic function in elderly patients.
- Compensatory mechanisms in the aging heart have limitations, with reduced atrial contribution and hypertrophy.
- Left ventricular mass index is a critical indicator of preserved cardiac function, with values >170 g/m2 predicting reduced cardiac output in hypertensive individuals.
Abstract:
As many as 81 patients suffering from stage-II essential hypertension (EH) and 20 practically healthy persons of the same age were examined. EH patients manifested derangement of systolic function of the left ventricle, attested to by a decrease of contractility in the first third of the systole. The lowering of the velocity of active relaxation, change in the structure of the filling of the left ventricle coupled with a decrease of the role of the rapid filling phase and a rise of the contribution of the phases of slow filling and the atrial systole were noted. A decrease of the blood flow velocity at the phase of the atrial systole was also noted, which points to a decrease of the compensatory role of the left atrium in elderly patients. As compared to younger patients, compensatory hypertrophy of the left ventricle was pronounced relatively less in elderly patients. In these patients, compensatory potentialities of the hypertrophied left ventricle are preserved until the index of the left ventricular mass exceeds 170 g/m2. The further growth of that indicator is associated with a decline of the cardiac output.