ISSN: 1859 - 2872
Left ventricular-arterial coupling in primary hypertensive patients
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Abstract
Objective: To investigate the left ventricular-arterial coupling and its components and the relation with morphology and function of left ventricle and arteries in primary hypertensive patients. Subject and method: In a descriptive study at 103 Military Hospital, Vietnam Military Medical University on 2 groups: A control one consisted of 69 healthy adults without cardiovascular diseases and a hypertensive group of 159 patients. Clinical data, Doppler echocardiography, electrocardiogram and blood pressure (BP) measurements were obtained. Ventricular-vascular coupling (VAC) was defined as Ea/Ees ratio, in which, Ea was calculated from stroke volume and systolic BP and indexed to body size (EaI). Ees was calculated by the modified single-beat method using systolic and diastolic BP, stroke volume and tNd. Result: In the hypertensive patients with left ventricular hypertrophy and with left ventricular dilation, VAC was higher and Ees was lower than those with normal left ventricle. In the patients with heart failure with reduced EF and NYHA IV, Ees was lowest and VAC was highest. Ea in the patients without and with heart failure were equivalent, but significantly higher than those in the control group. The correlation between EDVi and LVMi with Ees was negative and with VAC was positive (r = -0.58, -0.30 and r = 0.27, 0.29 respectively, p<0.05). Ea correlated negatively with EDVi (r= -0.42, p<0.05), but did not correlate with LVMi. The increase of Ea, Ees and VAC had a relation with the decrease of CO and CI (p<0.05). VAC had a positive correlation with BNP (r = 0.4, p<0.05), but Ea and Ees did not. Ees, Ea positively correlated with SVRi (r = 0.34 and 0.49 respectively; p<0.05), but VAC did not.The correlation between Ees and Ea was strong and positive (r = 0.661, p<0.001). Conclusion: In primary hypertensive patients, VAC and its components (Ea and Ees) have relations with arterial function, left ventricular morphology and function, as well as the severity of heart failure. In clinical practice, these parameters could be used to evaluate the cardiovascular function.
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References
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