Myocardial performance in asymptomatic essential hypertension.

ABSTRACT

Prevalence, determinants, and prognostic value of left ventricular function in subjects with asymptomatic essential hypertension are still incompletely known. The goal of this study was to investigate the effects of asymptomatic untreated essential hypertension on left ventricular structure and function. The left ventricular functions were assessed among 127 hypertensive and 80 healthy subjects. American society of echocardiography (ASE) convention was applied to measure the stroke volume, percentage ejection fraction, percentage fractional fiber shortening, cardiac output and cardiac index. The stroke volume, cardiac output and cardiac index were normal but significantly high among hypertensive compared to normotensive subjects (P<0.05). The percentage ejection fraction and fractional fiber shortening were significantly reduced among hypertensives compared to normotensives (P<0.05). The significant impairment of percentage fractional fiber shortening is due to alteration in dimension of left ventricular wall thickness, left ventricular cavity and left ventricular geometry. This carries prognostic implication and requires further documentations, investigations and researches. Percentage ejection fraction and fractional fiber shortening is considered a hallmark of normal left ventricular function. The left ventricular contractile state was negatively correlated to left ventricular after load parameters. So the main objective of management of hypertensive subjects should be, to reduce the after load to improve the left ventricular contractile state.