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Common carotid artery stiffness and patterns of left ventricular hypertrophy in hypertensive patients
P Boutouyrie1, S Laurent, X Girerd
1Department of Pharmacology, Broussais Hospital, Paris, France.
Insights
Essential hypertension alters common carotid artery function, with reduced arterial distensibility linked to cardiac concentric hypertrophy. Increased arterial volume, however, correlated with larger left ventricular cavity size in hypertensive patients.
Area of Science:
- Cardiovascular Physiology
- Vascular Biology
- Hypertension Research
Background:
- Essential hypertension is associated with structural and functional changes in the cardiovascular system.
- Left ventricular hypertrophy (LVH) is a common adaptation to chronic hypertension.
- The common carotid artery, as a capacitance vessel, may reflect systemic vascular changes in hypertension.
Purpose of the Study:
- To investigate the relationship between common carotid artery lumen diameter and function.
- To explore associations with different patterns of left ventricular hypertrophy in essential hypertensive patients.
Main Methods:
- Echotracking system for carotid artery measurements (cross-sectional area, distensibility, compliance).
- Echocardiography for left ventricular dimensions.
- Multivariate analysis in 86 uncomplicated essential hypertensive patients (untreated, treatment stopped, treated).
Main Results:
- Left ventricular end-diastolic volume index positively correlated with carotid cross-sectional area and compliance.
- Left ventricular mean wall thickness and mass-volume ratio negatively correlated with carotid distensibility and compliance.
- Left ventricular mass index positively correlated with carotid cross-sectional area and negatively with distensibility.
Conclusions:
- Geometric and functional changes in the common carotid artery accompany left ventricular geometric changes in hypertension.
- Reduced carotid artery distensibility is associated with cardiac concentric hypertrophy and remodeling.
- Increased carotid artery volume is linked to increased left ventricular cavity size.
Abstract:
The aim of this study was to determine the relationship between the lumen diameter and function of the common carotid artery, a vessel representative of the capacitance portion of the circulation, and the different patterns of left ventricular hypertrophy in uncomplicated essential hypertensive patients. Carotid luminal diastolic cross-sectional area, distensibility, and compliance were derived from measurements by a high-definition echotracking system. Left ventricular dimensions were from echocardiography. The 86 hypertensive patients included 31 who had never been treated (group 1), 31 in whom treatment had been stopped for at least 2 weeks (group 2), and 24 treated patients (group 3). In multivariate analysis of the population as a whole, the following relations were statistically independent of age, blood pressure, gender, and group: Left ventricular end-diastolic volume index was positively correlated to carotid luminal cross-sectional area (r = .46, P < .0001) and compliance (r = .47, P < .0001); left ventricular mean wall thickness and mass-volume ratio were negatively correlated to distensibility (r = -.68, P < .0001; r = -.46, P < .0001, respectively) and compliance (r = -.40, P < .0001; r = -.37; P < .001, respectively); and left ventricular mass index was positively correlated to luminal cross-sectional area (r = .23, P < .02) and negatively to distensibility (r = -.26, P < .01). These results indicate that geometric and functional changes in the common carotid artery accompany geometric changes in the left ventricle. More specifically, they suggest that a reduction in distensibility paralleled cardiac concentric hypertrophy and remodeling, whereas an increase in arterial volume paralleled increased left ventricular cavity size.