Rapid ventricular filling in left ventricular hypertrophy: II. Pathologic hypertrophy

To define the extent of left ventricular ejection and filling abnormalities in patients with mild hypertension, a non-imaging nuclear probe was used to generate high resolution time-activity curves in 25 patients with an average systolic blood pressure of 154 +/- 20 mm Hg and diastolic pressure of 98 +/- 8 mm Hg. The hypertensive patients did not meet electrocardiographic criteria for left ventricular hypertrophy, and none had evidence of ischemic or other cardiac disease. Compared with 25 age-matched normal subjects who had average systolic and diastolic pressures of 123 +/- 10 and 79 +/- 8 mm Hg, respectively, the hypertensive patients had a significantly lower ejection rate (2.00 +/- 0.20 versus 2.34 +/- 0.36 end-diastolic counts/s for the control group, p less than 0.05) and ejection fraction (58 +/- 4.9 versus 62 +/- 4.4) (p less than 0.05). The hypertensive patients had a markedly lower average rapid left ventricular filling rate (1.87 +/- 0.32 versus 2.69 +/- 0.41 counts/s for the control group, p less than 0.001). Although there was a modest inverse relation between echocardiographic left ventricular mass index and filling rate in the hypertensive patients (r = -0.59, p less than 0.01), 4 of 12 hypertensive patients with normal left ventricular mass index had a depressed filling rate. All of the hypertensive patients with increased left ventricular mass index had an abnormal left ventricular filling rate (less than 1.89 end-diastolic counts/s).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				H. P. Beyerbacht, H. J. Lamb, A. van der Laarse, H. W. Vliegen, F. Leujes, M. G. Hazekamp, A. de Roos, and E. E. van der Wall Aortic Valve Replacement in Patients with Aortic Valve Stenosis Improves Myocardial Metabolism and Diastolic Function Radiology, June 1, 2001; 219(3): 637 - 643. [Abstract] [Full Text] [PDF]

				R. J. Gibbons, K. Chatterjee, J. Daley, J. S. Douglas, S. D. Fihn, J. M. Gardin, M. A. Grunwald, D. Levy, B. W. Lytle, R. A. O'Rourke, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina) J. Am. Coll. Cardiol., June 1, 1999; 33(7): 2092 - 2197. [Full Text] [PDF]

				H. J. Lamb, H. P. Beyerbacht, A. van der Laarse, B. C. Stoel, J. Doornbos, E. E. van der Wall, and A. de Roos Diastolic Dysfunction in Hypertensive Heart Disease Is Associated With Altered Myocardial Metabolism Circulation, May 4, 1999; 99(17): 2261 - 2267. [Abstract] [Full Text] [PDF]

				B. M. Pluim, H. J. Lamb, H. W. M. Kayser, F. Leujes, H. P. Beyerbacht, A. H. Zwinderman, A. van der Laarse, H. W. Vliegen, A. de Roos, and E. E. van der Wall Functional and Metabolic Evaluation of the Athlete's Heart By Magnetic Resonance Imaging and Dobutamine Stress Magnetic Resonance Spectroscopy Circulation, February 24, 1998; 97(7): 666 - 672. [Abstract] [Full Text] [PDF]

				S. J. Kovacs, J. Rosado, A. L. M. McGuire, and A. F. Hall Can Transmitral Doppler E-Waves Differentiate Hypertensive Hearts From Normal? Hypertension, October 1, 1997; 30(4): 788 - 795. [Abstract] [Full Text]

				R. S. Vasan and D. Levy The Role of Hypertension in the Pathogenesis of Heart Failure: A Clinical Mechanistic Overview Arch Intern Med, September 9, 1996; 156(16): 1789 - 1796. [Abstract] [PDF]

				S. Yamamoto, T. N. James, K.-i. Sawada, M. Okabe, and K. Kawamura Generation of New Intercellular Junctions Between Cardiocytes : A Possible Mechanism Compensating for Mechanical Overload in the Hypertrophied Human Adult Myocardium Circ. Res., March 1, 1996; 78(3): 362 - 370. [Abstract] [Full Text]

				R. S. Vasan, E. J. Benjamin, and D. Levy Congestive Heart Failure With Normal Left Ventricular Systolic Function: Clinical Approaches to the Diagnosis and Treatment of Diastolic Heart Failure Arch Intern Med, January 22, 1996; 156(2): 146 - 157. [Abstract] [PDF]

				R. O. Bonow and J. E. Udelson Left Ventricular Diastolic Dysfunction as a Cause of Congestive Heart Failure: Mechanisms and Management Ann Intern Med, September 15, 1992; 117(6): 502 - 510. [Abstract] [PDF]

				E. G. Abinader, D. Sharif, M. Sagiv, and E. Goldhammer Doppler Assessment of the Effects of Isometric Stress on Left Ventricular Filling in Hypertensive Young Adults Angiology, December 1, 1989; 40(12): 1052 - 1057. [PDF]

				W. B. White, P. Schulman, E. J. McCabe, and H. M. Dey Average Daily Blood Pressure, Not Office Blood Pressure, Determines Cardiac Function in Patients With Hypertension JAMA, February 10, 1989; 261(6): 873 - 877. [Abstract] [PDF]

				R. C. Harizi, J. A. Bianco, and J. S. Alpert Diastolic Function of the Heart in Clinical Cardiology Arch Intern Med, January 1, 1988; 148(1): 99 - 109. [Abstract] [PDF]

				W. B. White and L. H. Baker Ambulatory Blood Pressure Monitoring in Patients With Panic Disorder Arch Intern Med, November 1, 1987; 147(11): 1973 - 1975. [Abstract] [PDF]

				G. E. Burch and J. A. Cronvich Two Pumps and One Heart: Studies and Theoretic Considerations Angiology, October 1, 1985; 36(10): 736 - 745. [Abstract] [PDF]

				B. P. J. Leeuwenburgh, P. Steendijk, W. A. Helbing, and J. Baan Indexes of diastolic RV function: load dependence and changes after chronic RV pressure overload in lambs Am J Physiol Heart Circ Physiol, April 1, 2002; 282(4): H1350 - H1358. [Abstract] [Full Text] [PDF]