Mechanical Deformation in Patients with Systemic Arterial Hypertension

Abstract

IntroductionHypertension is one of the most important healthy problems, and the prevalence is of around 20% of the population (variable in different regions of the world), and the hypertension is one of the most important risk factor for cardiovascular diseases, which are the leading causes of death in developed countries [1,2]. Both elevation of systolic pressure and diastolic blood pressure shows a continuous relationship with cardiovascular risk of stroke, coronary heart disease, heart failure, renal failure and peripheral arterial disease [3].Hypertension can cause left ventricular hypertrophy and hyperplasia of the smooth muscle cells and increased production of collagen and elastin tissue. Hypertension represents an increase in cardiac afterload and the compensatory mechanism of is the development of left ventricular concentric hypertrophy. However, unlike hypertrophy which occurs in athletes, the hypertrophy in hypertensive patients occurs with an increase of collagen tissue production, a fact that in the long term leads to left ventricular diastolic dysfunction and secondarily atrial dysfunction by increasing filling pressures predisposing to atrial fibrillation, and in advanced stages systolic dysfunction with dilatation of the cavity and the appearance of heart failure and ventricular arrhythmias [4]. In addition, hypertrophy of the ventricular wall increases the oxygen myocardial demands, which together with the increase incidence of coronary lesions favour myocardial ischemia [5].Several studies have found heterogeneous systolic alterations of the left ventricle (in the longitudinal, radial, and circumferential directions) in diverse clinical settings such as diabetes, hypertension, left ventricle hypertrophy, coronary artery disease, and heart failure [4,6]. The main aim of our study was focused in the assessment of left ventricular mechanical deformation in 20 patients with systemic arterial hypertension and 21 healthy controls to establish the differences in the left ventricular mechanical deformation. Materials and MethodsBetween March 2016 and February 2017, a comparative, observational, prospective, descriptive and analytical study was carried out in 41 subjects. The patients were evaluated consecutively in the Out-patients Clinic, National Institute of Cardiology "Ignacio Chávez". Twenty patients had systemic hypertension and 21 correspond to healthy controls. All participants signed the informed consent. Inclusion criteriaPatients older than 18 years NYHA functional class I/II with a diagnosis of systemic hypertension who had not had any prior surgical or interventional procedure and also patients without valvular or myocardial lesion. AbstractBackground: Systemic arterial hypertension represents the mayor risk factor for several cardiovascular diseases. In a large number of patients it affects the left ventricle by a compensating hypertrophy and posteriorly when this mechanism is insufficient, it leads to heart failure and therefore the patient requires regular echocardiographic monitoring. ...