AGING AND ESSENTIAL-HYPERTENSION - EFFECT OF LEFT-VENTRICULAR HYPERTROPHY ON CARDIAC-FUNCTION

This study was designed to analyze the cardiac effects of aging and of hypertension in patients with essential hypertension and with or with out left ventricular hypertrophy (LVH). Thirty-one patients <55 years old and 66 patients >64 years old with essential hypertension were div ided according to the presence or absence of LVH. Cardiac functional s tructure was assessed by 2D-guided M-mode echocardiography. The peak f illing rate and the duration of rapid filling were obtained by digitiz ing septal and posterior wall echoes. In the older group only was syst olic function significantly impaired in subjects with LVH when compare d with subjects without LVH [velocity of circumferential fiber shorten ing (L/msec): 1.40 +/- 0.24 v 1.18 +/- 0.25; fractional fiber shorteni ng (%): 43.06 +/- 5.02 v 36.26 +/- 7.1; ejection fraction (%): 81.1 +/ - 5.1 v 73.13 +/- 9.2; P <.05]. Older patients, even without LVH, show ed a longer duration of rapid filling (321.0 +/- 108.3 msec) and lower peak filling rate (7.01 +/- 1.86 cm/sec) in comparison with younger p ersons with or without LVH. In the older subjects the increase in left ventricular mass was associated with a decrease of velocity of circum ferential fiber shortening (r = -0.48, P < .01), fractional fiber shor tening (r = -0.40, P <.01), and ejection fraction = -0.50, P <.01), wh ereas there was no correlation in the younger group. The present findi ngs of impaired diastolic filling even in the absence of LVH in the el derly, and the deterioration of systolic function parallel to the incr ease in LV mass suggest that aging is associated with a decrease in th e number of functioning contractile elements per unit of cardiac mass. (C) 1998 American Journal of Hypertension, Ltd.