Document Detail

Abnormal left ventricular function occurs on exercise in well-treated hypertensive subjects with normal resting echocardiography.
MedLine Citation:
PMID:  20538670     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study tests the hypothesis that patients with treated hypertension with well-controlled blood pressure, without ventricular hypertrophy and normal resting echocardiography, may have abnormalities of ventricular function that are apparent only on exercise and contribute to symptoms of exertional dyspnoea. METHODS: Patients with hypertension with well-controlled blood pressure on medication and normal baseline echocardiography underwent cardiopulmonary exercise testing to determine their peak oxygen consumption (Vo(2)(max)), followed by rest and submaxinal supine exercise echocardiography (standard, tissue Doppler and speckle tracking). RESULTS: 30 patients with treated hypertension with a history of exertional dyspnoea (mean age 71+/-8 years; 18 women) and 22 age-matched healthy controls (70+/-6 years; 16 women) had rest and exercise images of sufficient quality for analysis. Both groups had comparable standard echocardiographic findings at rest. On exercise, the patients had reduced systolic longitudinal function (reserve index 0.97+/-1.34 vs 2.32+/-1.24, p=0.001), delayed early untwisting (20.4+/-7.6 vs 30.6+/-7.8%, p=0.001) and reduced ventricular suction (velocity propagation 10.6+/-10.9 vs 24.5+/-12.2 m/s, p<0.001) compared with healthy controls, which correlated with significantly reduced Vo(2)(max). CONCLUSION: Patients with treated hypertension with normal resting echocardiography can have exercise limitation associated with widespread systolic and diastolic left ventricular dysfunction on exercise. Normal resting echocardiography does not preclude the presence of significant functional abnormalities on exercise that can contribute to symptoms.
Yu Ting Tan; Frauke Wenzelburger; Eveline Lee; Grant Heatlie; Michael Frenneaux; John E Sanderson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  948-55     Citation Subset:  AIM; IM    
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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MeSH Terms
Dyspnea / etiology,  physiopathology
Echocardiography, Doppler / methods
Exercise / physiology*
Exercise Test / methods
False Negative Reactions
Hypertension / complications*,  drug therapy,  physiopathology
Observer Variation
Oxygen Consumption / physiology
Reproducibility of Results
Ventricular Dysfunction, Left / etiology*,  physiopathology,  ultrasonography
Grant Support
PG/06/106/21472//British Heart Foundation
Comment In:
Heart. 2010 Jun;96(12):906-7   [PMID:  20538663 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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