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Published on: June 14, 2016
Myocardial performance in asymptomatic essential hypertension
Anil Kumar Pandey1, Asim Das, Ashutosh Kumar
1Department of Physiology, GSL Medical College, Rajahmundry. drpandeyak@yahoo.co.in
Insights
Asymptomatic essential hypertension impairs left ventricular function, reducing ejection fraction and fractional fiber shortening. Management should focus on reducing afterload to improve cardiac contractile state in hypertensive patients.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Left ventricular function in asymptomatic essential hypertension is not fully understood.
- Essential hypertension can impact cardiac structure and function over time.
- Early detection of cardiac changes is crucial for prognosis.
Purpose of the Study:
- To investigate the effects of asymptomatic untreated essential hypertension on left ventricular structure and function.
- To assess cardiac parameters using echocardiography in hypertensive individuals.
- To explore the relationship between left ventricular afterload and contractile state.
Main Methods:
- Echocardiography was used to assess left ventricular function in 127 hypertensive and 80 healthy subjects.
- Standard American Society of Echocardiography (ASE) conventions were applied for measurements.
- Key parameters measured included stroke volume, ejection fraction, fractional fiber shortening, cardiac output, and cardiac index.
Main Results:
- Hypertensive subjects showed normal but significantly higher stroke volume, cardiac output, and cardiac index compared to normotensive controls.
- Percentage ejection fraction and fractional fiber shortening were significantly reduced in hypertensive individuals.
- Impaired fractional fiber shortening correlated with alterations in left ventricular dimensions and geometry.
Conclusions:
- Asymptomatic essential hypertension negatively affects left ventricular contractile function, indicated by reduced ejection fraction and fractional fiber shortening.
- Left ventricular afterload is a key factor influencing cardiac contractile state in hypertension.
- Reducing afterload is a critical therapeutic goal for improving left ventricular function in hypertensive patients.
Abstract:
Prevalence, determinants, and prognostic value of left ventricular function in subjects with asymptomatic essential hypertension are still incompletely known. The goal of this study was to investigate the effects of asymptomatic untreated essential hypertension on left ventricular structure and function. The left ventricular functions were assessed among 127 hypertensive and 80 healthy subjects. American society of echocardiography (ASE) convention was applied to measure the stroke volume, percentage ejection fraction, percentage fractional fiber shortening, cardiac output and cardiac index. The stroke volume, cardiac output and cardiac index were normal but significantly high among hypertensive compared to normotensive subjects (P<0.05). The percentage ejection fraction and fractional fiber shortening were significantly reduced among hypertensives compared to normotensives (P<0.05). The significant impairment of percentage fractional fiber shortening is due to alteration in dimension of left ventricular wall thickness, left ventricular cavity and left ventricular geometry. This carries prognostic implication and requires further documentations, investigations and researches. Percentage ejection fraction and fractional fiber shortening is considered a hallmark of normal left ventricular function. The left ventricular contractile state was negatively correlated to left ventricular after load parameters. So the main objective of management of hypertensive subjects should be, to reduce the after load to improve the left ventricular contractile state.
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