TY - JOUR
T1 - Normalization of cardiac structure and function after regression of cardiac hypertrophy
AU - Habib, Gabriel B.
AU - Mann, Douglas L.
AU - Zoghbi, William A.
N1 - Funding Information:
From the Section of Cardiology, Veterans Affairs Medical Methodist Hospital, and Baylor College of Medicine. Supported in part by a grant from Pfizer Labs, New York. Received for publication Sept. 10, 1993; Nov. 1, 1993. Reprint requests: Gabriel B. Habib, MD, Section of Cardiology, Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX 71030. Copyright @ 1994 by Mosby-Year Book, Inc. 0002~8703/94/$3.00 + 0 4/l/54642
Funding Information:
Computational assistancew as provided by the CLINFO project, funded by grant RR-00350 from the Division of Research Resources, National Institutes of Health, Bethesda, Md. We thank Donna Espadas for secretarial assistance and Paulette Stone, Annie R. Wilson, and David Brown for technical assistance.
PY - 1994/8
Y1 - 1994/8
N2 - Previous studies have shown regression of left ventricular hypertrophy after pharmacologic treatment of hypertensive patients; however, the impact of regression of left ventricular hypertrophy on systolic function and on left and right ventricular diastolic function remains controversial and is difficult to assess because previous studies have not included concurrently studied age-matched control groups. Left ventricular mass, systolic function, and left and right ventricular diastolic function were assessed in 27 hypertensive patients, aged 43 ± 6 years, by echocardiographic and Doppler studies before and 1, 3, 5, and 7 months after treatment. Left ventricular mass and ventricular function were concurrently evaluated in 27 age-matched normotensive subjects. Treatment with antihypertensive agents resulted in a significant (p < 0.001) reduction in diastolic blood pressure of 15 mmHg, measured at 1 month and sustained throughout the study. In response to hemodynamic unloading, left ventricular mass index decreased from 129 ± 30 gm/m2 at baseline to 105 ± 26 (p < 0.05) and 88 ± 14 gm/m2 (p < 0.05) at 1 and 3 months of treatment, respectively, and remained unchanged over the subsequent 4 months. After 3 months of treatment, left ventricular mass index was similar in treated hypertensive and control subjects. Systolic function, assessed in terms of the relationship between shortening fraction and end-systolic wall stress, was unchanged throughout the treatment period and was no different from that in control subjects. However, patients with an initially depressed shortening fraction experienced a greater increase in shortening fraction during treatment compared to those with an initially normal shortening fraction (11% ± 4% vs 5% ± 5%, p < 0.01) and showed an improvement in the relationship between shortening fraction and end-systolic wall stress during treatment. Ventricular filling dynamics improved during the first 3 months of treatment, after which they were unchanged. Ventricular filling dynamics were similar in treated hypertensive patients and control subjects. In conclusion, sustained hemodynamic unloading of the left ventricle results in normalization of left ventricular mass, systolic function, and left and right ventricular diastolic filling dynamics, compared to those in age-matched control subjects.
AB - Previous studies have shown regression of left ventricular hypertrophy after pharmacologic treatment of hypertensive patients; however, the impact of regression of left ventricular hypertrophy on systolic function and on left and right ventricular diastolic function remains controversial and is difficult to assess because previous studies have not included concurrently studied age-matched control groups. Left ventricular mass, systolic function, and left and right ventricular diastolic function were assessed in 27 hypertensive patients, aged 43 ± 6 years, by echocardiographic and Doppler studies before and 1, 3, 5, and 7 months after treatment. Left ventricular mass and ventricular function were concurrently evaluated in 27 age-matched normotensive subjects. Treatment with antihypertensive agents resulted in a significant (p < 0.001) reduction in diastolic blood pressure of 15 mmHg, measured at 1 month and sustained throughout the study. In response to hemodynamic unloading, left ventricular mass index decreased from 129 ± 30 gm/m2 at baseline to 105 ± 26 (p < 0.05) and 88 ± 14 gm/m2 (p < 0.05) at 1 and 3 months of treatment, respectively, and remained unchanged over the subsequent 4 months. After 3 months of treatment, left ventricular mass index was similar in treated hypertensive and control subjects. Systolic function, assessed in terms of the relationship between shortening fraction and end-systolic wall stress, was unchanged throughout the treatment period and was no different from that in control subjects. However, patients with an initially depressed shortening fraction experienced a greater increase in shortening fraction during treatment compared to those with an initially normal shortening fraction (11% ± 4% vs 5% ± 5%, p < 0.01) and showed an improvement in the relationship between shortening fraction and end-systolic wall stress during treatment. Ventricular filling dynamics improved during the first 3 months of treatment, after which they were unchanged. Ventricular filling dynamics were similar in treated hypertensive patients and control subjects. In conclusion, sustained hemodynamic unloading of the left ventricle results in normalization of left ventricular mass, systolic function, and left and right ventricular diastolic filling dynamics, compared to those in age-matched control subjects.
UR - http://www.scopus.com/inward/record.url?scp=0027991394&partnerID=8YFLogxK
U2 - 10.1016/0002-8703(94)90487-1
DO - 10.1016/0002-8703(94)90487-1
M3 - Article
C2 - 8037101
AN - SCOPUS:0027991394
SN - 0002-8703
VL - 128
SP - 333
EP - 343
JO - American heart journal
JF - American heart journal
IS - 2
ER -