[Hypertensive cardiopathy. Phonomechanocardiographic study and review of its physiopathological mechanisms]. / Cardiopatía hipertensiva. Estudio Fonomecanocardiográfico y revision de sus mecanismos fisiopatológicos.

Sixty four patients with essential hypertension were studied by phonocardiographic systolic time intervals. Prolongation of the pre-ejection period (PEP) at expense of the isovolume contraction time and of the true isovolume contraction time, which suggests myocardial contractile depression due to the increase in after-load. The significant increase, in rise of mean velocity of ventricular pressure suggests that the Anrep phemomena is used by the human heart as a compensatory mechanism in systemic hypertension. Ejection fraction in hypertensives was significantly lower (P less than 0.001) than that of normal controls, which indicates subclinical depression of ventricular function in the former. Myocardial hypertrophy can be considered as a compensatory mechanism which appears late in systemic hypertension and helps normalize ventricular performance and MVO2. It is clinically detected by an s-4 (registered by phonocardiographic tracings) and by an increase in the "A" index and the apexcardiogram (14.5 +/- 8%). The authors conclude that hypertensive heart disease can be identified early through the functional adaptations wich produce detrimental physiopathological reactions to the heart compensated initially by homeometric autorregulation and latter by myocardial hypertrophy.