Left ventricular ejection fraction and its response to therapy in essential hypertension
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Essential hypertension patients often have elevated left ventricular ejection fraction (LVEF) and abnormal exercise responses. Therapy, particularly with captopril, can normalize LVEF during isotonic exercise.
Area of Science:
- Cardiology
- Hypertension Research
Background:
- Essential hypertension is linked to cardiovascular changes.
- Left ventricular ejection fraction (LVEF) assessment is crucial in hypertensive patients.
Purpose of the Study:
- To evaluate LVEF at rest and during exercise in essential hypertension.
- To assess the impact of antihypertensive therapy on LVEF response to exercise.
Main Methods:
- Assessed LVEF in 16 hypertensive patients before and after treatment.
- Utilized treadmill (isotonic) and handgrip (isometric) exercise tests.
- Administered captopril and propranolol as therapeutic interventions.
Main Results:
- Untreated hypertensives showed a correlation between blood pressure and LVEF.
- No significant LVEF change with exercise pre-therapy.
- Captopril normalized isotonic exercise-induced LVEF increase.
- Propranolol caused LVEF decrease during isometric stress.
Conclusions:
- Essential hypertension may present with increased LVEF and abnormal isotonic exercise response.
- Therapy, like captopril, can reverse exercise-induced LVEF abnormalities.
- Different antihypertensive drugs have varied effects on LVEF during specific exercise types.
Abstract:
Left ventricular ejection fraction at rest and during treadmill and isometric handgrip exercise were determined in 16 patients with essential hypertension (mean age 47.4 years) before and after therapy. The untreated hypertensive patient showed a linear correlation between mean blood pressure and LVEF (r = 0.62, p less than 0.01). The relation of sitting, resting LVEF with systolic blood pressure was highly significant (r = 0.88, p less than 0.001). Prior to therapy no significant change in LVEF in response to exercise was noted. After therapy with captopril, a normal isotonic exercise response occurred consisting of a highly significant increase in ejection fraction (p less than 0.0025). Subjects receiving propranolol had a fall in LVEF with isometric stress (p less than 0.0025). These data suggest an increased ejection fraction in patients with essential hypertension when all other parameters of the heart are normal and an abnormal response to isotonic exercise which may be reversed with therapy.