Document Detail

Right ventricular remodelling in systemic hypertension: a cardiac MRI study.
MedLine Citation:
PMID:  21628720     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Consistent evidence shows an impact of systemic haemodynamic overload on the right ventricle, but its functional and structural consequences have received scarce attention for several reasons including the difficult application of conventional imaging techniques due to the complex shape and orientation of that cardiac chamber.
AIMS: To evaluate whether mild to moderate, uncomplicated hypertension associates with abnormal right ventricular structure and function and how those changes relate to homologous changes in the left ventricle. Data were acquired by steady-state free-precession cardiac MRI, the state of the art tool for the morphological and functional evaluation of the right ventricle.
MATERIALS AND METHODS: Twenty-five (12 women) uncomplicated, untreated, essential hypertensive patients were compared with 24 (13 women) sedentary normotensive controls of comparable age. Wall thickness, indexed ventricular mass, end-diastolic volumes, early peak filling rate, a correlate of diastolic relaxation, and ejection fraction were measured at both ventricles. Remodelling index, the ratio of ventricular mass to end-diastolic volume, was used as an index of concentricity.
RESULTS: Right ventricular mass index, ventricular wall thickness and remodelling index were greater in hypertensive subjects and associated with reduced peak filling rate, a pattern consistent with concentric right ventricular remodelling. In the hypertensive group, positive, highly significant biventricular correlations existed between indexed mass, early peak filling rate and ejection fraction.
CONCLUSIONS: Systemic hypertension associates with concentric right ventricular remodelling and impaired diastolic function, confirming that the unstressed ventricle is not immune to the effects of systemic hypertension. Structural and functional right ventricular adaptation to systemic hypertension tends to parallel the homologous modifications induced by systemic haemodynamic overload on the left ventricle.
Giancarlo Todiere; Danilo Neglia; Sergio Ghione; Enza Fommei; Paola Capozza; Giacinta Guarini; Giulia Dell'omo; Giovanni Donato Aquaro; Mario Marzilli; Massimo Lombardi; Paolo Camici; Roberto Pedrinelli
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-05-31
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  97     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-11     Completed Date:  2011-11-02     Revised Date:  2012-02-02    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1257-61     Citation Subset:  AIM; IM    
Istituto di Fisiologia Clinica, Fondazione G Monasterio, Pisa, Italy.
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MeSH Terms
Disease Progression
Follow-Up Studies
Hypertension / complications,  diagnosis,  physiopathology*
Magnetic Resonance Imaging, Cine / methods*
Middle Aged
Myocardial Contraction
Reproducibility of Results
Severity of Illness Index
Stroke Volume
Ventricular Dysfunction, Right / diagnosis,  etiology,  physiopathology
Ventricular Function, Right / physiology*
Ventricular Remodeling / physiology*
Comment In:
Heart. 2012 Feb;98(3):263; author reply 263   [PMID:  22133922 ]

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

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