RELATIONSHIP BETWEEN LEFT-VENTRICULAR DIASTOLIC FUNCTION AND ATRIAL-NATRIURETIC-FACTOR IN NEVER-TREATED MILD HYPERTENSIVES

Using digitized M-mode echocardiograms, we evaluated the relationship between plasma atrial natriuretic factor (ANF) and morphofunctional ch aracteristics of the left ventricle (LV) in 24 mild hypertensive men, never treated, with normal renal function. For each subject we collect ed a blood sample for plasma ANF evaluation and, immediately after, we recorded the LV echocardiogram, All the patients had normal LV diasto lic diameter and systolic function; LV hypertrophy was present in 10 p atients, 7 of whom had left atrial enlargement, and 13 patients had im paired LV diastolic function. ANF was similar between patients with an d without LV hypertrophy, as well as between patients with and without left atrial enlargement, whereas ANF was significantly (P < .01) high er in patients with LV diastolic dysfunction than in patients with nor mal diastolic function. ANF was inversely correlated with both indices of diastolic function (peak lengthening rate and peak wall thinning r ate), whereas it did not correlate with blood pressure, heart rate, en d-systolic wall stress, and other LV parameters, In conclusion, from o ur results, ANF level in never-treated mild hypertensives is related n either to the degree of LV hypertrophy nor to the afterload, expressed as blood pressure or end-systolic wall stress, whereas it is mainly i nfluenced by LV diastolic function: the diastolic impairment induces a n increase in ANF level, probably through an increased atrial stretch. (C) 1997 American Journal of Hypertension, Ltd.