Normalization of left ventricular dysfunction in systemic hypertension.
BACKGROUND
In hypertensive heart disease, it is uncertain whether the impairment of left ventricular (LV) systolic function might be reverted by antihypertensive treatment.


OBJECTIVE
This study was undertaken to address the likelihood of recovery of LV dysfunction and to identify factors potentially related.


METHODS
Twenty-six patients with primary (n = 16) and renovascular (n = 10) hypertension participated in the study and were classified into Groups A (n = 12) and B (n = 14) according to normalization or persistent left ventricular dysfunction (fractional shortening < 0.30) after 36 weeks of follow-up. All patients received standard medical therapy and appropriate procedures for renovascular disease correction. Logistic regression analysis was used to identify variables associated with recovery.


RESULTS
Patients in Group A compared with those in Group B were younger (41 +/- 14 vs. 52 +/- 10 years; p < 0.05), had a greater frequency of renovascular hypertension (8 vs. 2; p < 0.05), showed shorter LV end-diastolic (54 +/- 5 vs. 61 +/- 8 mm; p < 0.05) and end-systolic dimensions (41 +/- 6 vs. 49 +/- 9 mm; p < 0.05), and lower mass index (215 +/- 64 vs. 261 +/- 47 g.m-2; p < 0.05) before treatment, whereas fractional shortening (0.24 +/- 0.4 vs. 0.20 +/- 0.5; p > 0.05) and diastolic blood pressure (116 +/- 12 vs. 122 +/- 19 mmHg; p > 0.05) were similar. On follow-up, Group A patients showed lower diastolic blood pressure (89 +/- 15 vs. 105 +/- 20 mmHg; p < 0.05) and mass index (142 +/- 34 vs. 222 +/- 40 g.m-2; p < 0.05). Logistic regression analysis identified systolic dimension and renovascular hypertension as factors associated with fractional shortening normalization.


CONCLUSIONS
The recovery of LV dysfunction is expected to occur most likely in patients with renovascular hypertension and the shortest systolic dimensions.
Frimm C de
C
C
Heart Institute, University of São Paulo Medical School, Brazil.
de Moraes
A V
AV
Medeiros
C C
CC
Esteves Filho
A
A
Marino
J C
JC
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D006978:Hypertension, Renovascular / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013599:Systole; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left / Q000187:drug effects
D000959:Antihypertensive Agents