gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Early cardiac structural adaptation of the right ventricle parallels those of the left ventricle in essential hypertension

Bei Patienten mit essenzieller Hypertonie zeigen sich parallel am linken und rechten Ventrikel frühe strukturelle Veränderungen

Meeting Abstract (Hypertonie 2003)

  • presenting/speaker T.K. Schwarz - Nürnberg, D
  • J. Schwab - Nürnberg, D
  • B.M.W. Schmidt - Nürnberg, D
  • M.P. Schneider - Nürnberg, D
  • I. Bär - Nürnberg, D
  • R.E. Schmieder - Nürnberg, D

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochV40

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2003/03hoch040.shtml

Veröffentlicht: 11. November 2004

© 2004 Schwarz et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background

In essential hypertension cardiac structural changes take place early and even may precede the development of established hypertension. Previous pilot studies found that structural changes of the right ventricle could also be detected in early essential hypertension. In the current study we re-analyzed this hypothesis by applying advanced technology.

Methods

In 32 white male patients aged 21 to 39 years (28.1 ± 5.8) with (n=23, 71.9%) and without (n=9, 28.1%) arterial hypertension, left ventricular mass (LVM) was determined by 2-D guided M-mode echocardiography. In parallel MRI scans of the left (LV) and right ventricle (RV) were done. Endsystolic (ESWS) and peak systolic wall stress (PSWS) were calculated as a measure for afterload. LVH was defined by LVM > 259g according to the Penn-convention. Arterial hypertension was defined as average blood pressure (BP) ³ 125/80 mmHg (according to the guidelines of the ESH 2003) by 24 h ambulatory blood pressure monitoring (ABPM).

Results

BP was 125/ 75 ± 8/7 mmHg (mean ± std) in the whole study population. No correlation be-tween BP and LV as well as RV mass could be detected. Furthermore no relationship of either ESWS or PSWS with RV and LV mass was found. One fourth of the patients (8 out of 32) had LVH. RV and LV mass calculated from MRI scans correlated with each other (r=0.426, p=0.034). LV mass by echo correlated with LV mass by MRI (r=0.679, p<0.001).

Conclusion

By applying MRI we observed a correlation between RV and LV mass in young patients with essential hypertension. In this early disease stage no relationship of 24h-BP, PSWS and ESWS - the major trophic stimuli - with structural changes of the left and right ventricle could be identified, although there were subjects with an increased LVM. Our data support the no-tion that non-hemodynamic mechanisms play a pivotal role for early cardiac changes taking place on the left as well as on the right ventricle.