Left ventricular function and contractile reserve in patients with hypertension. 2018

Matle J Fung, and Liza Thomas, and Dominic Y Leung
Department of Cardiology, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, New South Wales, Australia.

An impaired contractile reserve (CR) may be an early manifestation of left ventricular (LV) systolic dysfunction in hypertensive patients. Using normotensive patients as controls, we examined LV CR and its correlates in hypertensive patients. One hundred and twenty-nine (68 men, aged 58.6 ± 9.5 years, 73 had hypertension) patients underwent dobutamine echocardiography. Patients with significant coronary or valvular disease, previous myocardial infarction or revascularization, and diabetes were excluded. LV ejection fraction (LVEF), global longitudinal strain (GLS), circumferential, and radial strain were measured at rest and at low-dose dobutamine. Absolute CR was calculated as the difference in LVEF and multi-directional strain between low-dose dobutamine and their corresponding resting values. Relative CR is the ratio of absolute CR to their corresponding resting values. Hypertensive patients, compared with controls, have significantly impaired GLS at rest (-16.8 ± 2.2% vs. -19.6 ± 1.5%, P < 0.0001) and at low-dose dobutamine (-17.9 ± 2.7% vs. -22.8 ± 2.6%, P < 0.0001). Absolute and relative GLS CR were significantly lower in hypertensive patients (-1.1 ± 2.1% vs. -3.2 ± 2.2% and 7.4 ± 13.9% vs. 16.4 ± 11.7%, respectively, both P < 0.001). Circumferential strain was preserved at rest but impaired at low-dose dobutamine in hypertensive patients (-23.0 ± 4.1% vs. -25.2 ± 3.4%, P = 0.002). There were no differences in LVEF or radial strain between the groups. LV wall thickness and systolic blood pressure correlated significantly with GLS at rest and at low-dose dobutamine. LV wall thickness is the only independent correlates of absolute CR. Compared with controls, hypertensive patients have impaired LV GLS at rest and impaired CR despite normal LVEF. Impaired CR correlated with LV wall thickness but independent of prevailing blood pressure.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013599 Systole Period of contraction of the HEART, especially of the HEART VENTRICLES. Systolic Time Interval,Interval, Systolic Time,Intervals, Systolic Time,Systoles,Systolic Time Intervals,Time Interval, Systolic,Time Intervals, Systolic
D016277 Ventricular Function, Left The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance. Left Ventricular Function,Function, Left Ventricular,Functions, Left Ventricular,Left Ventricular Functions,Ventricular Functions, Left
D018487 Ventricular Dysfunction, Left A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall. LV Diastolic Dysfunction,LV Dysfunction,LV Systolic Dysfunction,Left Ventricular Diastolic Dysfunction,Left Ventricular Dysfunction,Left Ventricular Systolic Dysfunction,Diastolic Dysfunction, LV,Dysfunction, LV,Dysfunction, LV Diastolic,Dysfunction, LV Systolic,Dysfunction, Left Ventricular,LV Diastolic Dysfunctions,LV Dysfunctions,LV Systolic Dysfunctions,Left Ventricular Dysfunctions,Systolic Dysfunction, LV

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