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Left ventricular morphology and function in mild to moderate essential hypertension
Insights
Mild to moderate essential hypertension (EH) in men causes left ventricular (LV) hypertrophy and diastolic dysfunction, detectable by echocardiography. These changes indicate early cardiac remodeling without LV dilation.
Area of Science:
- Cardiology
- Hypertension Research
- Echocardiography
Background:
- Essential hypertension (EH) is a prevalent cardiovascular risk factor.
- Left ventricular (LV) remodeling is a known complication of sustained hypertension.
- Early detection of LV changes is crucial for managing hypertensive heart disease.
Purpose of the Study:
- To investigate echocardiographic findings of left ventricular (LV) morphology and function in males with mild to moderate essential hypertension (EH).
- To compare LV characteristics between hypertensive patients and normotensive controls.
- To identify potential echocardiographic markers of early hypertensive cardiac changes.
Main Methods:
- Echocardiographic examination of 150 males with mild to moderate EH.
- Comparison of LV parameters (wall thickness, mass, function) with 20 normotensive men.
- Assessment of systolic and diastolic LV function indices.
Main Results:
- Significant increase in LV wall thickness (81%) and LV mass (67%) in hypertensive patients, indicative of concentric hypertrophy.
- Absence of LV hypertrophy in normotensive controls.
- Normal or slightly elevated systolic LV function, but impaired diastolic function suggested by indirect indices.
- Decreased LV end-systolic wall stress, indicating compensatory hypertrophy without dilation.
- Correlation between LV hypertrophy degree and systemic blood pressure in some patients.
Conclusions:
- Mild to moderate EH induces significant changes in LV morphology and function.
- Echocardiography is effective in detecting these early cardiac alterations.
- Concentric LV hypertrophy may be a characteristic feature of early-stage EH.
- Diastolic dysfunction is an early functional impairment in hypertensive individuals.
Abstract:
150 males with mild to moderate essential hypertension [EH] were examined echocardiographically and the findings in the left ventricle [LV] were compared with those in 20 normotensive men. Increased LV wall thickness and LV mass was found in 81% and 67% of hypertensives respectively in contrast with a complete absence of LV hypertrophy in normotensives. The former showed also a tendency to the concentric type hypertrophy, which can be considered a characteristic feature of the 2nd stage [WHO] EH. There was an almost uniform incidence of asymmetric septal hypertrophy in the two groups [12 vs. 10%]. Decreased LV end-systolic wall stress in EH was a sign of compensatory myocardial hypertrophy without LV dilatation. The hypertensives exhibited a normal or slightly elevated systolic LV function. On the other hand, some indirect indices of LV properties [peak rate of LV relaxation and left atrial dimension] were indicative of diastolic function impairment. A slight but significant correlation between the degree of LV hypertrophy and systemic blood pressure at rest was found in a part of hypertensive patients. The study indicates that mild to moderate EH leads to some changes in LV morphology and function, which can be easily recognized by echocardiography.