F. Perticone et al., Relationship between left ventricular mass and endothelium-dependent vasodilation in never-treated hypertensive patients, CIRCULATION, 99(15), 1999, pp. 1991-1996
Citations number
40
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background-Hypertensive patients are characterized by development of both l
eft ventricular hypertrophy (LVH) and endothelial dysfunction
Methods and Results-We enrolled 65 never-treated hypertensive patients (36
men and 29 women aged 45.6+/-6.0 years) to assess the possible relationship
between echocardiographic left ventricular mass (LVM) and endothelium-depe
ndent vasodilation. Left ventricular measurements were performed at end dia
stole and end systole according to the recommendations of the American Soci
ety of Echocardiography and the Penn Convention. LVM was calculated with th
e Devereux formula and indexed by body surface area and height raised to th
e 2.7th power. The endothelial function was tested as responses of forearm
vasculature to acetylcholine (ACh), an endothelium-dependent vasodilator (7
.5, 15, and 30 mu g mL(-1) min(-1), each for 5 minutes), and sodium nitropr
usside (SNP), an endothelium-independent vasodilator (0.8, 1.6, and 3.2 mu
g mC(-1) min(-1), each for 5 minutes). Drugs were infused into the brachial
artery, and forearm blood flow (FBF) was measured by strain-gauge plethysm
ography. A negative significant relationship between indexed LVM and peak o
f increase in FBF was found during ACh infusions (r = -0.554; P<0.0001). in
addition, hypertrophic patients had a significantly lower responsive to AC
h than patients without LVH (the peak increase in FBF was 9.9+/-3.7 versus
16.1+/-8.1 mt per 100 mt of tissue per minute; P<0.0001). No significant co
rrelation was observed between LVM and FBF during SNP infusion.
Conclusions-Our data provide the first evidence that echocardiographic LVM
in hypertensive patients is inversely related to FBF responses to the endot
helium-dependent vasodilating agent ACh, but it is likely that both endothe
lium and LVM are damaged by hypertension.