Low exercise capacity is independent of LVMI despite significant change in diastolic function in young non complicated hypertensive patients

Abstract EN

Systemic hypertension is common disease that affect many organs specially the cardiovascular system.

Left ventricle hypertrophy is the main cardiac structural remodeling that occur in response to hypertension, furthermore.

The role of LVM in exercise intolerance in young patients with non complicated hypertension receiving antihypertensive drugs is still not well understood.

Aim: To assess the influence of LVMI on exercise capacity among young non complicated hypertensive patients.

Method: A total of 80 young age participants involved in this study.

They are grouped as group I (control subjects) , n= 40 (female: 17, male: 23) and group II (hypertensive patients), n= 40 (male: 27, female: 13) with different BMI levels.

All hypertensive patients are receiving regular antihypertensive medications.

Group II further subdivided into group A and B according to their exercise capacity levels.

Left ventricle mass (LVM) obtained as LVM=0.8[1.04(IVSd+ PWTd+ LVIDd)ᶟ- (LVIDd)ᶟ] +0.6 then divided by BSA to obtain LVMI.

Pulse wave and tissue Doppler analysis are conducted for each participant to get E/e, and PCWP.

All individuals subjected to treadmill test using Bruce protocol in order to obtain exercise capacity and to exclude IHD.

Results: Compared to normal subjects, well-controlled hypertensive patients have significant increase in LVMI (P value: 0.001) , E/e, (P value: 0.00) and PCWP (P value: 0.00).

Furthermore, they exhibited significant reduction in exercise capacity (P value: 0.00).

In hypertensive patients with exercise capacity ≤7 MET versus those with exercise capacity >7 MET, there is significant elevation of E/e, (P value: 0.01) and PCWP (P value: 0.01) are observed while no significant change of LVMI is observed (P value: 0.6).

Conclusion: LVMI is not correlated to exercise capacity despite significant diastolic function changes in young hypertensive patients who receiving regular antihypertensive treatments, reflecting that medications may modulate structural remodeling but not diastolic function.

Key words: Hypertension, exercise capacity, Left ventricle mass index, pulmonary