title: Baroreflex sensitivity correlates with left ventricular morphology and diastolic function in essential hypertension.
abstract: OBJECTIVE
  Arterial hypertension is a common cause of cardiac organ damage, inducing morphological and functional modifications. Spontaneous baroreflex sensitivity (BRS) control of the heart rate is a key mechanism of blood pressure homeostasis, and is impaired in patients with hypertension. This study sought to assess the association between BRS and left ventricular morphology and function.
  
  
  METHODS
  We studied 224 hypertensive patients (125 men; aged 47.8 +/- 10.8 years, mean +/- SD) compared with 51 normotensive control subjects (25 men, aged 45.7 +/- 12.5 years). Left ventricular morphology, systolic and diastolic function were evaluated by echocardiography. Spontaneous BRS was measured using the sequence method.
  
  
  RESULTS
  BRS was inversely associated with relative wall thickness (R = 0.17; P < 0.0001) and left ventricular mass index (R = 0.03; P = 0.01); in particular, BRS was significantly impaired in patients with concentric left ventricular remodelling (median [interquartile difference] 9.4 [4.1]) and hypertrophy (9.05 [3.9]) compared with the normal left ventricle (12.3 [5]; P < 0.001). BRS showed a significant association with systolic function evaluated by midwall fractional shortening (r = 0.28; P < 0.001), stroke volume (r = 0.27; P < 0.001), stroke work (r = 0.17; P < 0.05), and fractional shortening (r = 0.17; P < 0.05). BRS was significantly decreased in patients with diastolic dysfunction; it was lower in patients with diastolic dysfunction compared with both the control group and hypertensive patients with normal diastolic function.
  
  
  CONCLUSIONS
  BRS is associated with left ventricular morphology, systolic and diastolic function in hypertensive patients. In particular BRS is impaired in patients with diastolic dysfunction. These findings suggest a role for BRS as a target in arterial hypertension.
authors.affiliation: Department of Medicine and Experimental Oncology, Hypertension Unit, University of Torino, Turin, Italy. alby.milan@libero.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
authors.forename: Mimma A
authors.initials: MA
authors.lastname: Caserta
authors.forename: Sara
authors.initials: S
authors.lastname: Del Colle
authors.forename: Antonio
authors.initials: A
authors.lastname: Dematteis
authors.forename: Fulvio
authors.initials: F
authors.lastname: Morello
authors.forename: Franco
authors.initials: F
authors.lastname: Rabbia
authors.forename: Paolo
authors.initials: P
authors.lastname: Mulatero
authors.forename: Natesa G
authors.initials: NG
authors.lastname: Pandian
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
mesh_terms: D000328:Adult; D017704:Baroreflex / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged