The relationship of left ventricular function and mass in arterial hypertension. An echo and apexcardiographic comparison with sportsmen and controls.

Abstract

Non-invasive assessment of left ventricular function by M-mode echocardiography and calibrated apex-cardiology was performed in 48 male hypertensives, without cardiac failure, 15 top class endurance athletes and 20 normotensive controls. The aim of the study was to assess the effect of left ventricular hypertrophy on left ventricular function and to determine whether similar abnormalities of left ventricular function occurred regardless of whether hypertrophy was due to hypertension or athletic activity. Both the athletes and the hypertensives showed significantly increased left ventricular posterior wall thickness and left ventricular mass compared to controls. Left ventricular hypertrophy was most marked in the athletes but despite this severe hypertrophy, their left ventricular function was normal and some ejection phase indices of left ventricular performance were moderately increased. In contrast, some of the patients with hypertension had markedly reduced left ventricular function assessed from ejection phase indices such as ejection fraction and mean VCF although there was a wide range of ventricular function within the group as a whole. The extent of the abnormalities did not correlate with the extent of hypertrophy in the individual hypertensive patients. Therefore, greatly increased left ventricular mass in athletes was not associated with abnormal left ventricular function and severely abnormal left ventricular function in hypertensives was not related to the extent of hypertrophy.