ENDOTHELIAL FUNCTION AND LEFT-VENTRICULAR PERFORMANCE IN NEVER TREATED ESSENTIAL-HYPERTENSION

Similar to endothelial modulation of vascular tone, nitric oxide (NO) released from the coronary and endocardial endothelium may modulated L V performance with an improvement of LV diastolic distensibility, The aim of the present study was to assess a potential relationship betwee n endothelial function and LV performance in essential hypertension. T hirty-nine normotensive subjects INT) and 46 never treated hypertensiv e patients (HT) were grouped according to the renal vasodilatatory res ponse to infusion of L-arginine (30 g within 60 min). HT patients resp onders to. L-arginine (n = 19) were defined by an increased greater th an or equal to 5 % of renal plasma flow (RPF) estimated by the clearan ce of I-Hippuran. LV mass index and afterload-corrected fractional sho rtening were determined by echocardiography. Mitral peak early (E) and late (A) diastolic flow velocity were assessed by Doppler. Results of ANOVA were (means +/- SD) : [GRAPHICS] In HT patients E/A was positiv ely correlated with %RPF (r = 0.27; p < 0.01) and negatively correlate d with age Ir = -0.52 p < 0.01) and systolic BP (r = -0.36 p < 0.01), in multiple regression analysis the relation between E/A and %RPF was dependent of age, This results confirm that aging and hypertension are the main determinants of the alteration of LV diastolic function. The link between these factors may be the endothelium which abnormal regu latory function secondary to aging and HT may be associated to an impa irment of NO dependent LV relaxation.