LEFT-VENTRICULAR STRUCTURAL AND FUNCTIONAL-CHARACTERISTICS IN PATIENTS WITH RENOVASCULAR HYPERTENSION, PRIMARY ALDOSTERONISM AND ESSENTIAL-HYPERTENSION

To investigate the effect of different etiologies of hypertension on l eft ventricular structure and function, we compared echocardiographic findings in 10 patients with renovascular hypertension (35 +/- 9 years ), 10 patients with primary aldosteronism (42 +/- 9 years), and 14 pat ients with essential hypertension (41 +/- 6 years). There were no sign ificant differences among the three groups in age, sex, body surface a rea, blood pressure, interventricular septal thickness, posterior wall thickness, left ventricular end-diastolic dimension or end-systolic d imension, relative wall thickness, left ventricular mass index, or spe ctrum of left ventricular adaptation (concentric remodeling, concentri c hypertrophy, or eccentric hypertrophy). There were no differences in systolic function or diastolic function, which was assessed in terms of the peak rate of increase in dimension normalized for left ventricu lar end-diastolic dimension (dD/dt/D), the relaxation time, and the re laxation time to peak velocity of lengthening among groups. Multiple r egression analysis showed that the systolic blood pressure was the mos t important determinant of left ventricular mass index (r = 0.56, P <. 01), and that left ventricular mass index was the most important deter minant of relaxation time and the relaxation time to peak velocity of lengthening (r = 0.48, P <.01 and r = 0.59, P < .01, respectively). Th e dD/dt/D was correlated only with left ventricular end-systolic dimen sion (r = 0.59, P <.01). Our results suggest that blood pressure may b e a strong determinant of left ventricular hypertrophy, irrespective o f the etiology of hypertension, and that the degree of hypertrophy may be related to left ventricular diastolic dysfunction in hypertensive patients with normal systolic function.