Relation of obesity, high sodium intake, and eccentric left ventricular hypertrophy to left ventricular exercise dysfunction in essential hypertension.
OBJECTIVE
To elucidate determinants of abnormal left ventricular functional responses to exercise in hypertensive patients.


METHODS
One hundred twenty-seven patients with uncomplicated essential hypertension were studied by rest and exercise radionuclide angiography and by echocardiography at rest.


RESULTS
The 24 patients with subnormal left ventricular ejection fraction at peak exercise (less than 54%) were similar in age and rest and exercise blood pressures to the 103 with normal exercise ejection fraction, but were more obese (p less than 0.005) and had greater left ventricular mass (p less than 0.03) and internal dimensions (p less than 0.001). The parallel increase in left ventricular chamber size and mass (eccentric hypertrophy) in the group of patients with exercise dysfunction was associated with higher resting end-systolic wall stress (p less than 0.001) and abnormal increases of end-systolic left ventricular volume from rest to peak exercise (p less than 0.001). Multivariate analysis revealed that exercise left ventricular dysfunction was independently associated with higher left ventricular mass (p less than 0.0005), end-systolic wall stress (p less than 0.001), dietary sodium intake (p less than 0.01), and body mass index (p less than 0.03).


CONCLUSIONS
Among patients with uncomplicated essential hypertension, abnormal functional responses to exercise are strongly associated with eccentric ventricular hypertrophy, obesity, and high sodium intake.
Blake
J
J
Department of Medicine, New York Hospital-Cornell Medical Center, New York 10021.
Devereux
R B
RB
Borer
J S
JS
Szulc
M
M
Pappas
T W
TW
Laragh
J H
JH
D006332:Cardiomegaly / Q000150:complications / Q000503:physiopathology*; D002932:Cineangiography; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009200:Myocardial Contraction / Q000502:physiology; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D005082:Physical Exertion / Q000502:physiology*; D011875:Radionuclide Angiography; D012737:Sex Factors; D012982:Sodium, Dietary / Q000494:pharmacology*; D013318:Stroke Volume
D012982:Sodium, Dietary