Left ventricle remodeling in men with moderate to severe volume-dependent hypertension.
We evaluated the influence of increased intravascular volume on the heart anatomy in salt-sensitive types of hypertension, represented by primary aldosteronism (PA) and low-renin essential hypertension (LREH). Echocardiography was performed in 128 males with moderate to severe or resistant hypertension: 44 patients had PA, 40 patients had LREH and 44 patients had normal-renin essential hypertension (NREH). Groups were comparable in demographic characteristics, blood pressure, duration of hypertension and previous antihypertensive treatment. Patients with PA and LREH, in comparison with NREH patients, showed both greater end-systolic (37.6±5.4 and 35.6±4.5 vs 32.6±4.4 mm, p<0.001 and p<0.05) and end-diastolic (56.1±4.5 and 54.0±4.8 vs 50.4±5.1 mm; p<0.001 and p<0.01) left ventricle (LV) diameter. There were no significant differences either in LV wall thicknesses or LV mass, although a higher percentage of patients with PA and LREH met the criteria of eccentric hypertrophy (p<0.001 and p<0.05 respectively). Aldosterone concentration was positively related to LV cavity dimensions, whether wall thicknesses were rather associated with blood pressure levels. In conclusion, plasma volume overload was identified as an important factor influencing LV remodeling in PA and LREH, whether due to excessive aldosterone levels in PA or other pathophysiological mechanisms.
3rd Department of Medicine, Charles University, Prague, Czech Republic. tomas.indra@vfn.cz
Tomás
T
Indra
Robert
R
Holaj
Tomás
T
Zelinka
Ondrej
O
Petrák
Branislav
B
Strauch
Ján
J
Rosa
Zuzana
Z
Somlóová
Jan
J
Malík
Tomás
T
Janota
Jaromír
J
Hradec
Jirí
J
Widimsky
D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D004562:Electrocardiography; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010953:Plasma Volume / Q000502:physiology*; D012083:Renin / Q000097:blood; D014463:Ultrasonography; D020257:Ventricular Remodeling / Q000187:drug effects / Q000502:physiology*
D000959:Antihypertensive Agents; D012083:Renin