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Diastolic dysfunction, hypertrophy and hypertension ventricular-arterial uncoupling treatment

Daniel Piskorz1, Luis Keller2, Luciano Citta2

  • 1Cardiology Institute of the Rosario British Sanatorium, Rosario, Argentina. danielpiskorz@ciudad.com.ar.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|October 13, 2022
PubMed

Insights

Hypertension treatment improved cardiovascular mechanical efficiency and cardiac reverse remodeling. Patients with the worst ventricular-arterial uncoupling showed the most significant benefits, including reduced left ventricular hypertrophy and improved diastolic function.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Hypertension Research

Background:

  • Hypertension significantly impacts cardiovascular mechanics and structure.
  • Understanding treatment effects on ventricular-arterial coupling (VAC) is crucial for managing hypertensive heart disease.
  • Cardiac reverse remodeling and mechanical efficiency changes are key indicators of treatment efficacy.

Purpose of the Study:

  • To evaluate the effects of hypertension treatment on cardiovascular mechanical efficiency.
  • To assess cardiac reverse remodeling in hypertensive patients undergoing treatment.
  • To investigate the relationship between ventricular-arterial coupling (VAC) and treatment outcomes.

Main Methods:

  • Observational prospective study of 288 consecutive hypertensive patients.
  • Measurements included left ventricle mass index, diastolic function, left ventricular end systolic elastance (Ees), effective arterial elastance (Ea), and VAC.
  • Patients were analyzed in quartiles based on baseline VAC, with a 2-year follow-up.

Main Results:

  • Hypertension treatment led to significant improvements in VAC, primarily driven by a reduction in Ees.
  • The frequency of left ventricular hypertrophy (LVH) decreased significantly in the lowest VAC quartile (from 31.9% to 10.8%).
  • Normal diastolic function improved across all VAC quartiles, with the most pronounced improvements seen in patients with initially worse VAC.

Conclusions:

  • Hypertension treatment enhances cardiovascular mechanical efficiency and promotes cardiac reverse remodeling.
  • Patients with the most severe ventricular-arterial uncoupling experienced the greatest benefits from treatment.
  • Regression of left ventricular hypertrophy was specifically observed in patients with the worst VAC, highlighting its role in guiding therapeutic strategies.

Keywords:
Cardiac reverse remodelingCardiovascular mechanical efficiencyDiastolic dysfunctionHypertension treatmentVentricular arterial coupling

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