Longitudinal left ventricular contractility in young isolated systolic hypertensives

Piskorz, Daniel; Citta, Luciano; Keller, Luis; Tommasi, Alicia

doi:10.1016/j.hipert.2017.02.002

Cited by 1 publication

(2 citation statements)

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“…The observed differences in our study may have been reduced due to the comparison of ISH patients to adolescents with WCH, who on their own may have some autonomic nervous system dysregulation [28]. The study by Li et al additionally observed increased cardiac contractility, previously also reported in young adults with ISH, which can be considered as another indicator of increased sympathetic activity [27,29]. In our study, the increased cardiac contractility could be indicated by the observed increased LV SV in ISH patients, without differences in LV EDV or HR between the study groups and by significantly faster PWV in proximal parts of the aorta.…”

Section: Isolated Systolic Hypertension Pathophysiologycontrasting

confidence: 47%

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Isolated systolic hypertension is associated with increased left ventricular mass index and aortic stiffness in adolescents: a cardiac magnetic resonance study

Sarnecki

Obrycki

Feber

et al. 2022

Journal of Hypertension

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Objectives: Despite the high prevalence of isolated systolic hypertension (ISH) among hypertensive adolescents, its clinical significance is not determined. In addition, it is hypothesized that ISH with normal central blood pressure (BP) in young patients is a benign phenomenon and was hence labeled spurious hypertension (sHTN).Methods: Using cardiac magnetic resonance we evaluated a group of 73 patients with suspected primary hypertension, aged 13-17 years (median: 16.9, interquartile range 15.8-17.4; 13 girls), in whom, based on 24-h ambulatory BP monitoring either ISH (n ¼ 30) or white-coat hypertension (WCH) (n ¼ 43) was diagnosed. Based on noninvasive central BP measurement 13 participants in the ISH group were classified as having sHTN and 17 were diagnosed with true hypertension.Results: Compared with WCH adolescents, ISH patients presented with higher indexed left ventricular mass index (LVMI) (P < 0.001), maximal left ventricular (LV) wall thickness (P < 0.001), LV concentricity (P ¼ 0.001) and more often had LV hypertrophy (47 vs. 14%, P ¼ 0.002). They had higher average pulse wave velocity (PWV) in the proximal aorta (P ¼ 0.016) and the whole thoracic aorta (P ¼ 0.008). In addition, we observed higher indexed LV stroke volume (P ¼ 0.025) in patients with ISH. The sHTN subgroup had significantly higher LVMI and aortic PWV, and more often had LV hypertrophy compared with the WCH group. The sHTN and true hypertension subgroups did not differ in terms of aortic PWV, LVMI or LV geometry. Conclusion:Compared with adolescents with WCH patients with ISH, including the sHTN subtype, have more pronounced markers of cardiac end-organ damage, higher aortic stiffness and stroke volume.

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Section: Isolated Systolic Hypertension Pathophysiologycontrasting

confidence: 47%

“…As shown in several studies, including a robust one by Holwerda et al [33], both chronic and acute sympathetic system activity is linked with arterial stiffness. The sympathetic tone could also be affecting aortic PWV values through increased cardiac contractility [27,29].…”

Section: Isolated Systolic Hypertension Pathophysiologymentioning

confidence: 99%