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[Left ventricular hypertrophy in hypertension: functional aspects].

M Lombardo1, G Zaini, W Colloca

  • 1Divisione Cardiologica IIa, Ospedale, Niguarda-Cà Granda, Milano.

Giornale Italiano Di Cardiologia
|December 1, 1987
PubMed
Summary

Essential hypertension often causes left ventricular hypertrophy (LVH) without other organ damage. This concentric hypertrophy maintains systolic function but impairs diastolic relaxation, especially with increased LV mass.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Diagnostic Imaging

Background:

  • Essential hypertension is a common condition.
  • Left ventricular hypertrophy (LVH) is a known complication of hypertension.
  • The functional consequences of LVH in uncomplicated hypertension require further elucidation.

Purpose of the Study:

  • To investigate the anatomical and functional changes of the left ventricle in patients with essential, uncomplicated hypertension.
  • To determine the prevalence of left ventricular hypertrophy (LVH) in this patient group.
  • To assess the impact of LVH on left ventricular systolic and diastolic function.

Main Methods:

  • M-mode echocardiography was performed on 50 hypertensive outpatients and 38 matched controls.
  • Patients were classified based on left ventricular mass index and relative wall thickness.

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  • Systolic performance (fractional shortening, mean-Vcf) and diastolic relaxation (time to peak filling rate) were evaluated.

    • Main Results:

    • Hypertensive patients exhibited increased left ventricular mass index and relative wall thickness, indicative of concentric hypertrophy.
    • 24 patients had significant LVH (LV mass > mean normal + 2 SD).
    • Systolic function was preserved or enhanced in all hypertensive subgroups.
    • Diastolic relaxation was impaired in hypertensive patients with LVH but preserved in those without LVH.
    • LV mass index correlated with blood pressure and diastolic filling time.

    Conclusions:

    • Echocardiographic left ventricular hypertrophy is a frequent finding in essential hypertension, even without overt target organ damage.
    • Concentric hypertrophy likely contributes to preserved systolic function by mitigating increased wall tension.
    • Left ventricular diastolic filling is impaired in proportion to the degree of myocardial hypertrophy.