Normalization of left ventricular dysfunction in systemic hypertension

Background: In hypertensive heart disease, it is uncertain whether the impa irment of left ventricular (LV) systolic function might be reverted by anti hypertensive treatment. Hypothesis: This study was undertaken to address the likelihood of recovery of LV dysfunction and to identify factors potentially related. Methods: Twenty-six patients with primary (n = 16) and renovascular (n = 10 ) hypertension participated in the study and were classified into Groups A (n = 12) and B (n = 14) according to normalization or persistent left ventr icular dysfunction (fractional shortening <0.30) after 36 weeks of follow-u p. All patients received standard medical therapy and appropriate procedure s for renovascular disease correction. Logistic regression analysis was use d to identify variables associated with recovery. Results: Patients in Group A compared with those in Group B were younger (4 1 +/- 14 vs. 52 +/- 10 years; p < 0.05), had a greater frequency of renovas cular hypertension (8 vs. 2; p < 0.05), showed shorter LV end-diastolic (54 +/- 5 vs. 61 +/- 8 mm; p < 0.05) and end-systolic dimensions (41 +/- 6 vs. 49 +/- 9 mm; p < 0.05), and lower mass index (215 +/- 64 vs. 261 +/- 47 g. m(-2); p < 0.05) before treatment, whereas fractional shortening (0.24 +/- 0.4 vs. 0.20 +/- 0.5; p > 0.05) and diastolic blood pressure (116 +/- 12 vs . 122 +/- 19 mmHg; p > 0.05) were similar. On follow-up, Group A patients s howed lower diastolic blood pressure (89 +/- 15 vs. 105 +/- 20 mmHg; p < 0. 05) and mass index (142 +/- 34 vs. 222 +/- 40 g.m(-2); p < 0.05). Logistic regression analysis identified systolic dimension and renovascular hyperten sion as factors associated with fractional shortening normalization. Conclusion: The recovery of LV dysfunction is expected to occur most likely in patients with renovascular hypertension and the shortest systolic dimen sions.