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Optimal Blood Pressure Control Improves Left Ventricular Torsional Deformation and Vascular Function in Newly

Stavros Tzortzis1, Ignatios Ikonomidis2, Hellen Triantafyllidi1

  • 1Department of Echocardiography and Laboratory of Preventive Cardiology, 2nd Cardiology Department, Attikon Hospital, National and Kapodistrian University of Athens, Rimini 1, Haidari, 12462, Athens, Greece.

Journal of Cardiovascular Translational Research
|January 4, 2020
PubMed

Insights

Optimizing blood pressure control in hypertensive patients improved left ventricular mechanics and coronary microcirculation. Reduced arterial stiffness was key to these cardiovascular benefits, enhancing overall ventricular-arterial interaction.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Physiology

Background:

  • Essential hypertension is linked to detrimental effects on cardiac structure and vascular health.
  • Left ventricular (LV) mechanics and coronary microcirculatory function are often impaired in hypertensive individuals.
  • Optimal blood pressure control's impact on these specific parameters requires further elucidation.

Purpose of the Study:

  • To investigate the effects of optimizing blood pressure control on cardiac deformation and vascular function in untreated essential hypertension.
  • To assess changes in arterial stiffness, coronary microcirculatory function, and LV longitudinal and torsional mechanics over 3 years of optimal blood pressure management.
  • To determine the independent association between reduced arterial stiffness and improvements in cardiac function and coronary flow reserve.

Main Methods:

  • Longitudinal study involving 200 untreated patients with essential hypertension.
  • Assessment of arterial stiffness, coronary microcirculatory function, and LV longitudinal and torsional deformation parameters at baseline and after 3 years of optimal blood pressure control.
  • Statistical analysis to identify independent predictors of improvement, adjusting for blood pressure changes.

Main Results:

  • Optimal blood pressure control for 3 years significantly improved LV longitudinal strain, twisting, and untwisting parameters.
  • Parallel improvements were observed in coronary microcirculatory function, arterial stiffness, LV mass, and ventricular-arterial interaction.
  • Reduction in arterial stiffness was independently associated with enhanced cardiac deformation markers and coronary flow reserve.

Conclusions:

  • Optimizing blood pressure control in hypertensive patients leads to significant improvements in LV longitudinal and torsional mechanics.
  • These improvements occur in parallel with reductions in arterial stiffness, enhancing ventricular-arterial interaction and coronary flow reserve.
  • Blood pressure optimization is a crucial strategy for mitigating cardiovascular remodeling and dysfunction in hypertension.

Keywords:
Arterial stiffnessCoronary flow reserveLV diastolic dysfunctionLV twisting and untwistingPulse wave velocity

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