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[Ultrasonic indicators of left ventricular function and elasticity of large vessels in newly diagnosed hypertensive
B Stancák1, K Belesová, S Misíková
1III. interná klinika FN L. Pasteura, Kosice.
Insights
Newly detected hypertension is linked to reduced large artery elasticity and impaired left ventricular diastolic function. Treatment should address blood pressure and other cardiovascular factors for better outcomes.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Physiology
Background:
- Untreated hypertension significantly impacts large vessel function.
- Left ventricular (LV) function is closely intertwined with vascular health.
- Early detection of vascular changes in hypertension is crucial.
Purpose of the Study:
- To assess large vessel alterations in newly diagnosed, untreated hypertensive patients.
- To investigate the association between vascular function and LV systolic/diastolic parameters.
- To compare vascular and cardiac function in hypertensive individuals versus normotensive controls.
Main Methods:
- Non-invasive indicators of vascular function (e.g., aortic arch tension, elastic module, pulse wave velocity).
- Echocardiography to evaluate LV parameters (e.g., LV weight, transmitral flow Doppler).
- Correlation analysis to link vascular and cardiac measurements.
Main Results:
- Hypertensive patients showed significant differences in LV weight and transmitral flow (E/A wave ratios).
- Reduced large vessel elasticity (higher elastic module, altered pulse wave velocity) was observed in hypertensives.
- Positive correlations found between age, blood pressure, LV weight, and vascular stiffness indicators.
Conclusions:
- Newly detected hypertension is associated with decreased large artery elasticity.
- This vascular dysfunction correlates with left ventricular hypertrophy and impaired diastolic function.
- Comprehensive hypertension management should include addressing vascular elasticity and LV function, not just blood pressure normalization.
Abstract:
The authors investigate the degree of alteration of large vessels in newly detected not treated hypertension, using a series of non-invasive indicators of vascular function and their association with selected parameters of systolic and diastolic left ventricular function in a group of 23 hypertonic patients and 23 subjects with normal blood pressure. The mean age of the examined subjects was 51.1 +/- 16.6 years. In the echocardiographic indicators a significant difference was found between the groups as regards the weight of the LV and in the ratios of amplitudes and time integrals of waves E and A of the Doppler record of transmitral flow. Comparison of functional and morphological indicators of large vessels revealed significant differences between groups as regards tension in the aortic arch, value of the elastic module (EMp), rate of pulse wave (RPVcf) and relative systolic rate of the arteriovelocitogram. Correlation analysis revealed positive relations between age, blood pressure and weight of the LV on the one hand and EMp, diameter of the femoral artery and RPVc on the other hand. The ratio of E/A waves and their time integrals displayed the same correlation with the pulse change and the tension of the aortic arch, with the peak and relative systolic rate of the arteriovelocitogram and a negative correlation with the EMp values. These results provide evidence of a reduced elasticity of the large vessels in the group of newly detected hypertonics, associated with left ventricular hypertrophy and a reduction of its diastolic function. This finding implies the necessity to focus treatment not only on normalization of blood pressure readings but to consider also other components of the hypertensive syndrome.