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Left ventricular mass index negatively correlates with heart rate variability in essential hypertension
K Kohara1, N Hara-Nakamura, K Hiwada
12nd Department of Internal Medicine, Ehime University School of Medicine, Japan.
Insights
Essential hypertension is linked to autonomic nervous system dysfunction. Reduced low frequency band and high frequency band power spectral analysis indicate increased left ventricular mass index, suggesting neuronal alterations contribute to end-organ damage.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Hypertension Research
Background:
- Essential hypertension is a major risk factor for cardiovascular disease.
- Autonomic nervous system (ANS) dysfunction is increasingly recognized in hypertensive patients.
- Left ventricular mass index (LVMI) is a marker of cardiac end-organ damage.
Purpose of the Study:
- To investigate the relationship between autonomic nervous activity and LVMI in essential hypertension.
- To determine if ANS alterations correlate with cardiac structural changes.
Main Methods:
- Fifty-three essential hypertensive patients underwent 24-hour Holter electrocardiography.
- Power spectral analysis of R-R intervals was used to assess autonomic activity (low frequency band and high frequency band).
- Urinary catecholamines and plasma catecholamine levels were measured.
Main Results:
- Left ventricular mass index showed a significant negative correlation with total low frequency band (r = -0.466, P < .001).
- Left ventricular mass index also showed a significant negative correlation with total high frequency band (r = -0.319, P < .02).
- These correlations suggest reduced autonomic nervous activity is associated with increased cardiac remodeling.
Conclusions:
- Autonomic nervous system alterations are present in essential hypertension.
- The degree of end-organ damage (LVMI) correlates with the extent of neuronal alterations.
- These findings highlight the role of ANS dysfunction in hypertensive cardiovascular complications.
Abstract:
To investigate the relationship between alterations of the autonomic nervous activity and left ventricular mass index in essential hypertensive patients, 24-h power spectral analysis of R-R intervals was performed using Holter electrocardiography. Fifty-three patients (mean age, 58.0 +/- 13.1 years; 30 men and 23 women) participated. The urinary excretions and plasma levels of catecholamines were also determined. Power spectral analysis of R-R interval was performed every 10 min by the maximum entropy method to obtain the low frequency band (LFB; 0.04 to 0.15 Hz), which is an index of both parasympathetic and sympathetic nervous activities, and the high frequency band (HFB; 0.15 to 0.4 Hz), which reflects parasympathetic nervous activity. LFB and HFB were averaged every hour to obtain hourly LFB and HFB levels. Total LFB and HFB were calculated as the summation of 24-h LFBs and HFBs. Left ventricular mass index showed a significant negative correlation with total LFB (r = -0.466, P < .001) and total HFB (r = -0.319, P < .02). These findings suggest that the level of end-organ damage correlates with neuronal alteration in essential hypertension.