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Left ventricular function, haemodynamics and certain indicators of neurohumoral control during submaximal exercise in
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Essential hypertension (HPT) impacts cardiac function during exercise. Stable HPT patients showed impaired cardiac output and higher left ventricular mass, negatively affecting heart pump function during physical activity.
Area of Science:
- Cardiology
- Exercise Physiology
- Hypertension Research
Background:
- Essential hypertension (HPT) is a significant cardiovascular risk factor.
- Understanding the haemodynamic response to exercise in HPT is crucial for patient management.
- Left ventricular hypertrophy (LVH) is a common complication of HPT.
Purpose of the Study:
- To investigate systemic and intracardiac haemodynamics during exercise in men with essential hypertension.
- To compare haemodynamic responses and neurohormonal activity between stable HPT, labile HPT, and healthy individuals.
- To assess the influence of left ventricular mass on cardiac function during exercise in HPT.
Main Methods:
- Echocardiography to assess haemodynamic indicators.
- Measurement of plasma catecholamines, renin, and cyclic nucleotides.
- Analysis of catecholamine excretion during rest and graded exercise.
- Inclusion of 22 men with essential hypertension (Stage I B-II B) and 10 healthy volunteers.
Main Results:
- Stable HPT patients exhibited distinct haemodynamic responses to exercise, including increased diastolic blood pressure and higher left ventricular mass.
- Cardiac output rose less, and end-systolic volume and peripheral vascular resistance dropped less in stable HPT compared to controls.
- Left ventricular ejection fraction did not increase in stable HPT patients, with a negative correlation between left ventricular mass and ejection fraction during exercise.
Conclusions:
- Left ventricular hypertrophy negatively impacts cardiac pump function during exercise in essential hypertension.
- Exercise haemodynamics and catecholamine excretion differ between stable HPT, labile HPT, and healthy individuals.
- These findings highlight the functional consequences of HPT on the cardiovascular system during physical exertion.
Abstract:
The study was carried out in 22 men with essential hypertension, stage I B-II B, aged 25 to 46 years, and in 10 healthy volunteers of the same age. The authors investigated indicators of systemic and intracardiac haemodynamics by echocardiography, determined the blood plasma catecholamine concentration, catecholamine excretion, renin and cyclic nucleotides activity in plasma, both at rest and during continuous submaximal graded exercise on a bicycle ergometer. The haemodynamic response to exercise differed in patients with stable HPT from healthy subjects and patients with labile HPT by an increase in diastolic blood pressure, a lesser drop in end-systolic volume and in total peripheral vascular resistance, a lesser rise in cardiac output, and by a substantially higher left ventricular mass. The left ventricular ejection fraction did not rise in patients with stable hypertension. In these patients, no statistically significant concentration of urine catecholamines and their urine excretion was observed, in contrast to the other two groups where these indicators were increased. A negative correlation was found between the left ventricular mass and the ejection fraction during exercise, which attests to a negative influence of left ventricular hypertrophy on the pump function of the heart during exercise in patients with essential hypertension.