Impact of asymptomatic hypertension on left ventricular functions.

ABSTRACT

(M-Mode Echocardiography was used to study the L.V. Systolic functions and the determinants of L.V. functions in subjects with asymptomatic Hypertension in comparison with subjects with normotensives. The functions were assessed among (60) sixty healthy subject and sixty (60) hypertensive subjects. The L.V. Function Parameters assessed by Echocardiography at lateral and septal sides of Left ventricle at the level of mitral annulus. Techholz's formula was used to measure the stroke volume, ejection fraction, cardiac output and cardiac index etc... The resting stroke volume, cardiac output and cardiac index were normal but significantly high among hypertensive subjects compared to normotensive subjects (P<0.05). The fractional fiber shortening (F.F.S.) and other parameters of L.V. contractile state were significantly reduced among hypertensives compared to normotensives (P<0.05). The significant Impairment of F.F.S. is due to alteration in dimension of L.V. wall thickness, L.V. cavity, L.V. geometry and fibrous changes in L.V. myocardium. This carries prognostic implication and requires further documentations, investigations and researches. As the R.A.A.S. play role in development of structural changes in L.V. wall drugs A.C.E. inhibiters i.e. Captopril and A.II.R. antagonist i.e. Losartan play significant role in improvement of L.V. functional changes. Even in the presence of normal L.V. systolic function, the L.V. hypertrophy is associated with altered L.V. geometry. Normal or near normal F.F.S. is considered a hallmark of normal L.V. function when L.V. geometry is normal, but not when L.V. hypertrophy type of geometry. Normal limit of F.F.S. should be reset to newer value. The L.V. contractile state was negatively correlated to L.V. after load parameters. So the main objective of management of hypertensive subjects should be, to reduce the after load to improve the L.V. contractile state.)