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KMID : 0376219870240010059
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Chonnam Medical Journal
1987 Volume.24 No. 1 p.59 ~ p.71
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LEFT VENTRICULAR FILLING PARAMETERS IN HYPERTENSIVE PATIENTS: EFFECTS OF THERAPY
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Abstract
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Hypertension and left ventricular hypertrophy are associated with characteristic abnormalities of left ventricular filling. M-mode echocardiographic indices of left ventricular filling were measured in 14 patients with essential hypertension (initial blood pressure, systolic; 184±30 mmHg, diastolic; 110±17mmHg, mean’s before and after 12 months of drug therapy with good control of blood pressure. Measure￢ments included left ventricular rapid filling velocity (LV RFV) and posterior wall rapid filling velocity (PW RFV) from the left ventricular echocardiogram and O-R slope from the posterior aortic wall motion on the aortic root echocardiogram. Similar measurements from paired studies in 13 normal control subjects indicated good repro￢ducibility. Using an upper limit of normal left ventricular muscle mass of 125g/m3, hypertensive patients were divided into H-1 group (<125g/m3) and H-2 group (>125g/m3). After 12 months of antihypertensive drug therapy, there was significant reduction of left ventricular mass in H-2 group compared to the initial value (209±106 g/m3 versus 164±96 g/m3, p<0.01) but not in H-1 group (113±7 g/m3 versus 111±21 g/m3, p>0. 05). Before drug therapy, there was significant reduction of LV RFV in H-2 group (5.7±2.7 cm/sec) compared to H-1 group(8.7±2.4 cm/sec, p<0.05). After drug therapy LV RFV increased only in H-2 group(7.5±3.2 cm/sec, p<0.05) but not in H-i group (10. 0±2.3 cm/sec). Before drug therapy, there was no significant difference in PW RFV between H-1(12.4±4.1 cm/sec) and H-2 group(10.5±2.9 cm/sec). After drug therapy, PW RFV increased only in H-2 group(12.4±3.7 cm/sec, p<0.05) but not in H-1 group (13.0±4.1 cm/sec). Before drug therapy there was significant reduction of O-R slope in H-2 group(2.4±1.0 cm/sec) compared to H-1 group (5.0±2.5cm/sec p<0. 05). After drug therapy, O-R slope didn´t increase in any of the group (H-1.; 5.8±1.7cm/sec, H-2; 2.7±0.6cs/sec).
These findings suggest that impaired left ventricular filling in hypertensive can be improved after partial regression of left ventricular hypertrophy and that O-R slope may be affected by other relatively irreversible factors.
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KEYWORD
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