Document Detail


Patients with a hypertensive response to exercise have impaired left ventricular diastolic function.
MedLine Citation:
PMID:  18360045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An exaggerated increase in systolic blood pressure prolongs myocardial relaxation and increases left ventricular (LV) chamber stiffness, resulting in an increase in LV filling pressure. We hypothesize that patients with a marked hypertensive response to exercise (HRE) have LV diastolic dysfunction leading to exercise intolerance, even in the absence of resting hypertension. We recruited 129 subjects (age 63+/-9 years, 64% male) with a preserved ejection fraction and a negative stress test. HRE was evaluated at the end of a 6-min exercise test using the modified Bruce protocol. Patients were categorized into three groups: a group without HRE and without resting hypertension (control group; n=30), a group with HRE but without resting hypertension (HRE group; n=25), and a group with both HRE and resting hypertension (HTN group; n=74). Conventional Doppler and tissue Doppler imaging were performed at rest. After 6-min exercise tests, systolic blood pressure increased in the HRE and HTN groups, compared with the control group (226+/-17 mmHg, 226+/-17 mmHg, and 180+/-15 mmHg, respectively, p<0.001). There were no significant differences in LV ejection fraction, LV end-diastolic diameter, and early mitral inflow velocity among the three groups. However, early diastolic mitral annular velocity (E') was significantly lower and the ratio of early diastolic mitral inflow velocity (E) to E' (E/E') was significantly higher in patients of the HRE and HTN groups compared to controls (E': 5.9+/-1.6 cm/s, 5.9+/-1.7 cm/s, 8.0+/-1.9 cm/s, respectively, p<0.05). In conclusion, irrespective of the presence of resting hypertension, patients with hypertensive response to exercise had impaired LV longitudinal diastolic function and exercise intolerance.
Authors:
Takeshi Takamura; Katsuya Onishi; Tadafumi Sugimoto; Tairo Kurita; Naoki Fujimoto; Kaoru Dohi; Takashi Tanigawa; Naoki Isaka; Tsutomu Nobori; Masaaki Ito
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  31     ISSN:  0916-9636     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-03-24     Completed Date:  2008-05-08     Revised Date:  2008-11-13    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  257-63     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Diastole*
Echocardiography, Doppler
Electrocardiography
Exercise / physiology*
Female
Humans
Hypertension / physiopathology*
Male
Middle Aged
Ventricular Function, Left*
Comments/Corrections
Comment In:
Hypertens Res. 2008 Jul;31(7):1485; author reply 1485-6   [PMID:  18957820 ]

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