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[A-wave in calibrated apex cardiogram in hypertension. Studies during rest and after exertion]
Insights
Hypertensive patients show increased left ventricular rigidity and atrial contractility, indicated by apexcardiography. Exercise tests revealed varied apexcardiographic responses in hypertensive individuals without significant correlation to hemodynamic changes.
Area of Science:
- Cardiology
- Physiology
Background:
- Hypertension is a significant risk factor for cardiovascular disease.
- Early detection of cardiac changes in hypertension is crucial for management.
- Apexcardiography offers a non-invasive method to assess cardiac mechanics.
Purpose of the Study:
- To investigate apexcardiographic differences in hypertensive patients compared to normal subjects.
- To evaluate the impact of dynamic exercise on apexcardiographic parameters in hypertension.
- To explore correlations between apexcardiographic findings and cardiac pump function or exercise-induced hemodynamic changes.
Main Methods:
- Apexcardiography was performed on 86 hypertensive patients without heart failure and a control group.
- Key apexcardiographic parameters analyzed included wave 'a' amplitude and maximal rate of wave rise (df/dt).
- A subset of 46 hypertensive patients underwent a dynamic exercise test (50W for 6 min) with post-exercise apexcardiography.
Main Results:
- Hypertensive patients exhibited statistically significant increases in wave 'a' amplitude and df/dt compared to controls.
- These findings suggest increased left ventricular rigidity and atrial contractility in hypertensive individuals.
- Post-exercise apexcardiography showed diverse responses (increase, decrease, or no change in a/T quotient) in hypertensive patients, with no correlation to hemodynamic changes.
Conclusions:
- Apexcardiography can detect subclinical cardiac alterations, specifically increased left ventricular rigidity and atrial contractility, in hypertensive patients.
- The response of apexcardiographic parameters to exercise in hypertension is variable and does not correlate with hemodynamic responses.
- Further research is warranted to understand the clinical implications of these findings in hypertension management.
Abstract:
Apexcardiographic examinations were carried out of 86 hypertensive patients without clinically manifest heart failure. The amplitude of the wave a (or the per cent fraction of the wave a of the total amplitude) and the maximal rate of wave rise, df/dta were statistically significantly higher in the hypertensive patients than in normal subjects. The findings are interpreted as a manifestation of an increased left ventricular rigidity and of an increased atrial contractility in hypertensive patients. No correlation was found between the apexcardiographic indicators checked and the indicators of the cardiac pump function. In 46 hypertensive patients, in addition, a dynamic exercise test was performed (50 W for 6 min); 1 minute after cessation of exercise an apexcardiogram was recorded. An increase in the a/T quotient (greater than or equal to 5%) was found in 20; a decrease (=5%), in 10; and no change (less than +/- 5%), in 16 hypertensive patients. The postexercise apexcardiographic changes had no correlations with haemodynamic changes occurring during exercise.