THE AFFECT OF THE REGRESSION OF THE LEFT VENTRICULAR HYPERTROPHY OF THE FUNCTIONAL CAPACITY IN HYPERTENSIVE PATIENTS: PP.35.487

Abstract

The objective of our study was to evaluate the effects of long-term antihypertensive treatment (after 8 years) in left ventricular hypertrophy (LVH), physical working capacity and arrhythmogenic marcers (QTc interval dispersion). Methods: 73 hypertensive patients were analyzed (44 male, aged 55.4 ± 8 years and 29 female aged 57.3 ± 6 years) who were an antihypertensive treatment with echocardiographic LVH (left ventricular mass index: 163 ± 30.3 g/m2). Each subject underwent two-dimensional and Doppler echocardiography, 12-lead electrocardiogram examination and exercise stress testing (Bruce - protocol). Results: Decrease of index LVM (I group – regression LVH) was achieved in 37 pts (51% - 172.2 vs 142.08 g/m2; p < 0.005), while in 36 pts it was increased (II group – progression LVH) (49% - 152.5 vs 158.7; ns). The reduction was due to a decrease in septal (13.4 vs 12.3; p < 0.05) and posterior wall thickness (11.4 vs 10.7 vs 1.2; p < 0.03), without changes in LV diameter. In patients of the I group ratio of the velocity time integrals of »E to »A mitral waves increase (E/A before Th 0.83 vs 0.92, p < 0.05). Patients with reduction of the left ventricular mass could be shown a significant reduction of QT dispersion from 64.9 ± 21.8 to 51.1 ± 15.9 ms (p < 0.009), opposite the patients with progression LVH (49.5 ± 14.5 vs 45 ± 12.5; ns). After regression LVH (I group), the functional capacity was increase (6.35 vs 7.56 METs; ns), decrease maximum systolic BP (205.7 vs 201.6 mmHg, ns), decrease peak double products (26.8 vs 26.2, ns), and significantly decrease double product/METs (2.6 vs 1.9, p < 0.05) in third minuts while it remained unchanged in pts of the II group. Conclusion: LVH regression in our patients was achieved by the decrease of wall thickness of the left ventricle and it is followed by the improvement of the functional capacity and by the reduction of QT dispersion.