EFFECTS OF VENTRICULAR GEOMETRY ON VENTRICULAR ARTERIAL COUPLING IN ESSENTIAL HYPERTENSION: PP.8.341

Abstract

Introduction: Echocardiography is used to assess ventrículo-arterial coupling (VAC) determined by the balance between the contractile properties of left ventricle (LV) and the pressure load. However ventricular geometry (VG) and cardiac hypertrophy (LVH) may modulate the VAC in hypertension (HT). Adaptative variations of aortic (Eal) and ventricular (Ees) elastances may be related with VAC changes within normal systolic function (SF). Objective: To characterize non-invasively the interaction between VG and VAC in HT within normal range of SF and VAC. Methods: We evaluated 23 consecutives hypertensive patients, age 53,3 ± 9,8, male 12(52,2%) female 11 (47,8%), SBP 134,78 ± 12,8 mmHg, DBP 82,47 ± 8,21 mmHg, with Doppler Echocardiography (Vivid 7,GE), using simple pulse method modified for the calculation of Ees and the ratio of end systolic pressure to stroke volume for Eal. VAC is the ratio Eal/Ees.Elastances were normalized to 100 g of ventricular mass. The following measurements were also determined: Mesoparietal fractional shortening, normalized systolic stress (MFS/STRESS), left atrial diameter (LA), correlation E/A (E/A), diastolic isovolumic relaxation time (Tau), systolic work index (SWI), systolic volume index (SVI) and peripheral vascular resistance index (PVRI). The VG was classified as: normal (Nor), concentric remodeling (Rem), concentric LVH (Conc) and eccentric LVH (Exc). Results: Significative differences on the VG were found in Nor with Rem: Ees(p < 0,05); Conc: LA(p < 0,01), Eal(p < 0,01), E/A(p < 0,01), SWI(p < 0,05); Exc: SWI(p < 0,05), SVI(p < 0,05), LA(p < 0,05), Eal(p < 0,01). Conclusions: In HT with SF and VAC within normal ranges, VG seems to affect VAC, contractility and ventricular performance. The noninvasive measurement of VG and related VAC, may be useful for diagnostic and therapeutic porpoises in early stages in hypertensive patients.