Right ventricular affection in essential hypertension

The present study was designed to assess right ventricular affection in systemic hypertension. This study included 60 males subjects, 20 healthy subjects as a control group; 20 hypertensives with mild or no LVH and 20 hypertensives with marked LVH. Thorough clinical examination, 12-lead surface ECG, chest X-ray and Echo-Doppler evaluation of systolic and diastolic functions of both left and right ventricles were done for each subject. This study showed that the thickness of right ventricular anterior wall was increased in the 2 hypertensive groups. Alteration in the systolic function of the right ventricle was represented by the increase in pulmonary maximum velocity [V-wax], and pulmonary ratio of [V[2]/AT]. Changes in right ventricular diastolic function were represented by augmentation of late filling of the right ventricle as indicated by increased tricuspid peak velocity A and time velocity integral of the A wave, In addition, early filling of the right ventricle in patients with less LVH was augmented as indicated by the increase in tricuspid peak velocity E and Peak filling rate normalised to stroke volume. Moreover, A-wave acceleration [AIAT-A] was increased in the 2 hypertensive groups and it was found to be the most sensitive parameter that can detect diastolic dysfunction in hypertensive patients. A direct significant correlation was found between both left and right systolic and diastolic indices in the hypertensives. In conclusion, the present study showed alteration in the structure and functions [systolic and diastolic] of the right ventricle in patients with essential hypertension with or without LVH. This RV affection seems not to be due to PH++ secondary to L.V.F. and it is not related to extent of LVH_.hence, some systemic factors may be involved in its pathogenesis

Effect of exercise on some hemorheologically variables in coronary artery disease

The importance of red cell deformability has relatively been recently recognized. Previous studies reported a reduction in red cell deformability with ischemic heart disease [IHD]. We aim to elucidate the role of abnormal haemorheology as a risk factor for IHD. This study included 40 subjects divided into two main groups: Control group [15 healthy males] and pathologic group [25 patients with IHD] which subdivided into 2 subgroups : Subgroup A [12 patients with healed myocardial infarction Ml] and Subgroup B [13 patients with angina pectoris. Each case in the study was subjected to thorough history taking and clinical examination, and determination of blood flow time, blood viscosity, plasma fibrinogen, haematocrite value and total serum cholesterol just before and after exercise tolerance test. We found a highly significant decrease in red cell deformability in IHD patients compared to control at rest while there was non significant difference in other parameters. The decrease in deformation of RBC's in IHD was mainly due to changes in properties of RBC's membrane. After exercise there was highly significant increase in blood flow time, [BFT] blood viscosity, fibrinogen and cholesterol in IHD compared to normal. The exercise tolerance was inferior in the diseased group compared to control, while it was better in Ml group compared with angina pectoris group. Exercise tolerance was limited where there was more disturbance in RBC's deformability. Thus it may be concluded that worsened RBC's deformability and other haemorheological factors may play a pathogenic, role in IHD. Hence studies of drugs that may improve RBC's deformability may add a new line in the management of IHD