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Published on: January 29, 2013
Assessment of left ventricular ejection force and sympathetic skin response in normotensive and hypertensive
Tarun Saxena1, Sanjay Patidar2, Manjari Saxena3
1Senior Consultant, Department of Internal Medicine, Mittal Hospital and Research Centre, Ajmer, India.
Insights
Essential hypertension involves increased ventricular ejection force (LVEF) and sympathetic activity in early stages. Later stages show normal sympathetic activity but elevated LVEF and stroke volume.
Area of Science:
- Cardiology
- Hypertension Research
- Physiology
Background:
- The underlying mechanisms of essential hypertension are not fully understood.
- The relationship between ventricular ejection force, sympathetic activity, and hypertension requires further clarification.
Purpose of the Study:
- To investigate the correlation between ventricular ejection force, sympathetic activity, and hypertension.
- To compare these parameters in hypertensive subjects versus normotensive controls.
Main Methods:
- A case-control study involving 100 hypertensive and normotensive subjects.
- Assessed left ventricular ejection force (LVEF) using echocardiography (aortic acceleration time and peak systolic velocity).
- Measured sympathetic skin response and categorized hypertension into stage 1 (group 2A) and stage 2 (group 2B).
Main Results:
- Hypertensive subjects exhibited significantly shorter aortic acceleration time and higher LVEF (p<0.0001).
- Stage 1 hypertension (group 2A) showed increased sympathetic activity (p<0.0001).
- Stage 2 hypertension (group 2B) demonstrated increased stroke volume (p<0.0001).
Conclusions:
- Stage 1 hypertension is characterized by heightened sympathetic activity, leading to increased LVEF and elevated blood pressure.
- Stage 2 hypertension may involve normal sympathetic activity, increased LVEF, and elevated stroke volume, potentially due to renal adjustments.
Background:
Pathophysiology of essential hypertension remains obscure. Correlation among ventricular ejection force, sympathetic activity, and hypertension is less clearly narrated in hypertensive subjects.
Aims And Objectives:
To assess correlation among ventricular ejection force, sympathetic activity, and hypertension in hypertensive subjects, and to be compared with normotensive subjects.
Methods:
This is a case-control study to assess left ventricular ejection force (LVEF) and sympathetic skin response, in normotensive (group 1; control), and hypertensive subjects (group 2; cases). 100 cases were selected. Subjects having stages 1 and 2 hypertension were categorized in groups 2A and 2B, respectively. LVEF was calculated by using echocardiography observing aortic acceleration time (AT) and peak systolic velocity. Comparison among groups was done by using one-way ANOVA.
Results:
Both groups were comparable. In group 2, 60 cases had stage 1 hypertension and 40 had stage 2 hypertension. Significantly short AT and significantly high LVEF were found in hypertension (groups 2A and 2B) (p<0.0001). Sympathetic activity was high in group 2A (p<0.0001). Stroke volume (SV) was high in group 2B (p<0.0001).
Conclusion:
Stage 1 hypertension is a stage of increased sympathetic activity, leading to increased LVEF and hypertension (resetting of baroreceptors); stage 2 hypertension is a stage of normal sympathetic activity, increased LVEF, increased SV, and hypertension (possibly a stage of shift of renal equilibrium curve/renal output curve and blood pressure to a newer level).
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