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Left Ventricular Myocardial Performance in Normotensive Offspring of Hypertensive Parents
Paolo Pattoneri1, Roberta Ceriati2, Vittoriano Belforti2
1Operative Unit of Cardiology, Hospital of Fidenza/San Secondo, AUSL di Parma, Parma, Italy. ppattoneri@yahoo.it.
Insights
Offspring of hypertensive parents show early signs of cardiovascular changes, including increased relative wall thickness (RWT) and potential concentric remodeling. These findings highlight the impact of genetic predisposition to hypertension on cardiac structure.
Area of Science:
- Cardiology
- Genetics
- Physiology
Background:
- Conflicting results exist regarding early cardiovascular alterations in offspring of hypertensive parents.
- Genetic predisposition to hypertension may influence cardiovascular development.
Purpose of the Study:
- To evaluate the influence of genetic predisposition to hypertension on left ventricular (LV) geometry and function.
- Comparing normotensive male offspring of hypertensive parents (EH+) with offspring of normotensive families (EH-).
Main Methods:
- Office and 24-h ambulatory blood pressure monitoring (ABPM).
- Conventional and Tissue Doppler Echocardiography (TDE).
- Assessment of myocardial performance index (MPI).
Main Results:
- EH+ group exhibited higher diastolic blood pressure and significantly greater relative wall thickness (RWT).
- LV mass index was unchanged, suggesting a trend towards concentric remodeling.
- Systolic and diastolic functions were similar between groups, but MPI correlated with RWT.
Conclusions:
- Genetic predisposition to hypertension is associated with LV concentric remodeling in normotensive offspring.
- Increased RWT independently predicts the condition of being an offspring of hypertensive parents.
- Findings suggest potential endothelial dysfunction and altered myocardial performance in EH+ subjects.
Introduction:
Early alterations in the cardiovascular system have been described in offspring of hypertensive parents, but with conflicting results.
Aim:
To evaluate the influence of genetic predisposition to hypertension on left ventricular (LV) geometry and function, 30 normotensive male offspring of hypertensive parents (EH+) and 30 matched offspring of normotensive families (EH-), were studied.
Methods:
All subjects underwent office and 24-h ambulatory blood pressure monitoring (ABPM), conventional and Tissue Doppler Echocardiography (TDE), including assessment of myocardial performance index (MPI).
Results:
EH+ showed an increase in office BP with statistical significance in diastolic BP (84 ± 7 vs 73 ± 6 mmHg; p < 0.05). Relative wall thickness (RWT) was greater in EH+ (0.37 ± 0.05 vs 0.31 ± 0.03; p < 0.05) and significantly related to the EH+ condition at the univariate analysis (p < 0.003), whilst the LV mass index was unchanged (84.3 ± 14 vs 80 ± 17 g/m2; p = NS), suggesting a trend towards concentric remodeling. Systolic and diastolic function, in both ventricles, were superimposable in the two groups. The MPI was higher in EH+ (0.49 ± 0.10 vs 0.45 ± 0.08; p = NS) and significantly correlated to RWT (r = 0.47, p < 0.01). However, at the stepwise multiple regression analysis, only the condition of EH + was independently associated with RWT (p <0.006). RWT, according to ROC curves analysis, predicted the condition of EH+ (cutoff 0.359, specificity 89%, sensitivity 82%).
Conclusion:
Current results provide information about LV myocardial performance in EH+ subjects, related to a LV concentric remodeling and to endothelial dysfunction.
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