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Related Experiment Videos

Malignant hypertension: cardiac structure and function at presentation and during therapy.

L M Shapiro, D G Beevers

    British Heart Journal
    |May 1, 1983
    PubMed
    Summary

    Antihypertensive treatment improved some cardiac abnormalities in malignant hypertension, but impaired diastolic function persisted. Some patients developed malignant hypertension without left ventricular hypertrophy, showing abnormal relaxation and filling despite preserved pump function.

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    Area of Science:

    • Cardiology
    • Hypertension Research
    • Medical Imaging

    Background:

    • Malignant hypertension presents with severe elevations in blood pressure and potential end-organ damage.
    • Understanding the cardiac implications and treatment response in malignant hypertension is crucial for patient outcomes.

    Purpose of the Study:

    • To investigate the cardiac effects of malignant hypertension using electrocardiograms, chest radiographs, and echocardiograms.
    • To assess the impact of antihypertensive treatment on cardiac function and structure in patients with malignant hypertension.

    Main Methods:

    • Studied 16 patients with malignant hypertension before and after antihypertensive treatment, comparing them to 8 with severe benign hypertension.
    • Utilized electrocardiograms (ECG), chest radiographs, and digital apex echocardiograms to evaluate cardiac parameters.

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  • Assessed changes in left ventricular hypertrophy, ischemia, mitral valve opening, and myocardial relaxation dynamics.

    • Main Results:

    • Adequate blood pressure reduction was achieved in most patients, resolving retinopathy but with one fatality.
    • Electrocardiographic left ventricular hypertrophy remained unchanged; lateral ischemia resolved in seven patients.
    • Malignant hypertensives showed delayed mitral valve opening and abnormal relaxation/contraction dynamics, which partially improved post-treatment but diastolic dysfunction persisted.

    Conclusions:

    • Antihypertensive therapy can improve some cardiac functional abnormalities in malignant hypertension, including incoordinate contraction.
    • Impaired diastolic function persists after blood pressure reduction, similar to benign hypertension, suggesting altered myocardial properties.
    • Malignant hypertension can occur without left ventricular hypertrophy, characterized by abnormal relaxation, contraction, and filling, despite preserved pump function.