Relation between cardiac hypertrophy and forearm vascular structural changes before and during long-term antihypertensive treatment

Agabiti‐Rosei, Enrico; Muiesan, María Lorenza; Geri, Alessandro; Romanelli, Giuseppe; Montani, Giovanni; Muiesan, G

doi:10.1016/0002-9343(88)90217-3

Cited by 15 publications

(2 citation statements)

References 11 publications

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“…1,2 The lack of correlation between LV hypertrophy and peripheral vascular hypertrophy assessed by MFVR is somewhat controversial, because a significant relation was observed in a Danish subgroup of about 30 patients in which LV mass was measured by magnetic resonance imaging. 2 Since other groups have found a positive relation between LV mass and MFVR, 27,28 this is probably because of the higher reproducibility of LV mass measured by magnetic resonance imaging.…”

Section: Discussionmentioning

confidence: 99%

Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy

et al. 2003

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Vascular hypertrophy and insulin resistance have been associated with abnormal left ventricular (LV) geometry in population studies. We wanted to investigate the influence of vascular hypertrophy and insulin resistance on LV hypertrophy and its function in patients with hypertension. In 89 patients with essential hypertension and electrocardiographic LV hypertrophy, we measured blood pressure; insulin sensitivity by hyperinsulinaemic euglucaemic clamp; minimal forearm vascular resistance (MFVR) by plethysmography; intima-media cross-sectional area of the common carotid arteries (IMA) by ultrasound; and LV mass, relative wall thickness (RWT), systolic function and diastolic filling by echocardiography after two weeks of placebo treatment. LV mass index correlated to IMA/height (r=0.36, P=0.001), serum insulin (r=-0.25, P<0.05), plasma glucose (r=-0.34, P<0.01), and showed a tendency towards a correlation to insulin sensitivity (r=0.21, P=0.051), but was unrelated to MFVR. Deceleration time of early diastolic transmitral flow positively correlated to IMA/height (r=0.30, P<0.01). The ratio between early and atrial LV filling peak flow velocity negatively correlated to MFVR(men) (r=-0.30, P<0.05). Endocardial and midwall systolic LV function were not related to vascular hypertrophy, plasma glucose, serum insulin or insulin sensitivity. In conclusion, insulin resistance was not related to LV hypertrophy or reduced LV function. However, high thickness of the common carotid arteries was associated with LV hypertrophy and high deceleration time of early diastolic transmitral flow. High MFVR was associated with low ratio between early and atrial LV filling peak flow velocity. This may suggest that systemic vascular hypertrophy contributes to abnormal diastolic LV relaxation in patients with hypertension and electrocardiographic LV hypertrophy.

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Section: Discussionmentioning

confidence: 99%

Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy

et al. 2003

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“…1 These can be seen from the left ventricle down to the resistance vessels, and there is a strong relationship between left ventricular mass and small artery structure. 2,3 Resistance to blood flow is provided by arteries with an internal diameter (ID) of Յ300 m, 4 and in subcutaneous vessels, there is clear evidence for an increased media thickness:lumen diameter ratio in essential hypertension, which is proportional to the severity of the blood pressure. 1,5,6 Such findings appear to be representative of other vascular beds, with similar results being reported in the small intestine and the heart.…”

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confidence: 99%

αV Integrins Are Necessary for Eutrophic Inward Remodeling of Small Arteries in Hypertension

Heerkens

Shaw²,

Ryding³

et al. 2006

Hypertension

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Abstract-Human essential hypertension is characterized by eutrophic remodeling of small arteries, with little evidence of hypertrophy. Likewise, vessels of young hypertensive TGR(mRen2)27 animals have undergone similar structural alterations. The role of integrins in resistance arteries of TGR(mRen2)27 during the eutrophic-remodeling process was examined as blood pressure rose. Initially, 8 ␣ and 3 ␤ integrins were identified and levels of expression investigated using RT-PCR. As pressure increased and remodeling advanced, integrin expression profiles revealed that only ␣V was significantly raised. In conjunction, we confirmed elevated integrin ␣V protein levels in TGR(mRen2)27 rat arteries and localization to the media using immunofluorescence. ␤1 and ␤3, but not ␤5 integrin subunits were coprecipitated with integrin ␣V and are implicated in the eutrophic remodeling process. Administration of a peptide antagonist of ␣V␤3 abolished remodeling but enhanced growth, indicating that hypertrophy supervened as a response to hypertensioninduced increases in wall stress. We have established that the only upregulated integrin, the ␣V subunit of integrin ␣V␤3, has a crucial role in the hypertensive remodeling process of TGR(mRen2)27 rat resistance arteries. During hypertensive remodeling, functions of specific ␣V␤3-extracellular matrix interactions are likely to allow vascular smooth muscle cell-length autoregulation, which includes a migratory process, to maintain a narrowed lumen after a prolonged constricted state. A lthough the causes of high blood pressure may vary, sustained hypertension is associated with changes in cardiovascular structure. 1 These can be seen from the left ventricle down to the resistance vessels, and there is a strong relationship between left ventricular mass and small artery structure. 2,3 Resistance to blood flow is provided by arteries with an internal diameter (ID) of Յ300 m, 4 and in subcutaneous vessels, there is clear evidence for an increased media thickness:lumen diameter ratio in essential hypertension, which is proportional to the severity of the blood pressure. 1,5,6 Such findings appear to be representative of other vascular beds, with similar results being reported in the small intestine and the heart. 7,8 The nature of the structural change that is effected by hypertension is a rearrangement of the preexisting material in the vascular wall without a major hypertrophic response. 9 This has been termed eutrophic inward remodeling, which is initiated by vascular smooth muscle cell (VSMC)-length autoregulation. 10 Constriction causes shortening of VSMCs and a return to normal length after dissipation of the stimulus; however, prolonged constriction causes cells to increase in overlap. This functional adaptation to prolonged vasoconstriction is thought to occur because it is an energetically favored mechanism to preserve a reduced lumen diameter for long periods. 10 All models of hypertension appear to demonstrate eutrophic remodeling in small arteries, although to differing extents. ...

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Angiotensin-Converting Enzyme Inhibitors in Hypertension

Materson¹

1994

Arch Intern Med

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Introduction of the first angiotensin-converting enzyme (ACE) inhibitor, captopril, in 1981 marked a major advance in the treatment of essential hypertension. This article reviews the 12 years of clinical experience during which it and other ACE inhibitors have become recognized as first-line agents for treating hypertension. The benefits of ACE inhibition in diabetic patients are being defined. In recent years, beneficial effects on glucose handling, left-ventricular mass, quality of life, renal function, and myocardial protection have become recognized. For these reasons, and because of their excellent safety profile, ACE inhibitors are now widely used for the treatment of hypertensive patients.

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Relation between cardiac hypertrophy and forearm vascular structural changes before and during long-term antihypertensive treatment

Cited by 15 publications

References 11 publications

Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy

Are left ventricular mass, geometry and function related to vascular changes and/or insulin resistance in long-standing hypertension? ICARUS: a LIFE substudy

αV Integrins Are Necessary for Eutrophic Inward Remodeling of Small Arteries in Hypertension

Angiotensin-Converting Enzyme Inhibitors in Hypertension

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