Patients with treated hypertension and normal resting echocardiography had reduced systolic longitudinal function on exercise compared to healthy controls (reserve index 0.97 vs 2.32, p=0.001).
Case-Control (n=52)
Does exercise echocardiography reveal left ventricular dysfunction in well-treated hypertensive patients with exertional dyspnoea and normal resting echocardiography compared to healthy controls?
Exercise echocardiography can unmask significant systolic and diastolic left ventricular dysfunction in treated hypertensive patients with exertional dyspnoea who have normal resting echocardiograms.
Absolute Event Rate: 0.97% vs 2.32%
p-value: p=0.001
OBJECTIVES: This study tests the hypothesis that patients with treated hypertension with well-controlled blood pressure, without ventricular hypertrophy and normal resting echocardiography, may have abnormalities of ventricular function that are apparent only on exercise and contribute to symptoms of exertional dyspnoea. METHODS: Patients with hypertension with well-controlled blood pressure on medication and normal baseline echocardiography underwent cardiopulmonary exercise testing to determine their peak oxygen consumption (Vo(2)(max)), followed by rest and submaxinal supine exercise echocardiography (standard, tissue Doppler and speckle tracking). RESULTS: 30 patients with treated hypertension with a history of exertional dyspnoea (mean age 71+/-8 years; 18 women) and 22 age-matched healthy controls (70+/-6 years; 16 women) had rest and exercise images of sufficient quality for analysis. Both groups had comparable standard echocardiographic findings at rest. On exercise, the patients had reduced systolic longitudinal function (reserve index 0.97+/-1.34 vs 2.32+/-1.24, p=0.001), delayed early untwisting (20.4+/-7.6 vs 30.6+/-7.8%, p=0.001) and reduced ventricular suction (velocity propagation 10.6+/-10.9 vs 24.5+/-12.2 m/s, p<0.001) compared with healthy controls, which correlated with significantly reduced Vo(2)(max). CONCLUSION: Patients with treated hypertension with normal resting echocardiography can have exercise limitation associated with widespread systolic and diastolic left ventricular dysfunction on exercise. Normal resting echocardiography does not preclude the presence of significant functional abnormalities on exercise that can contribute to symptoms.
Tan et al. (火曜日)は、治療された高血圧の症例対照研究を実施しました (n=52)。治療された高血圧と健康な対照群との比較において、運動時の収縮期長軸機能（予備能指数）が評価されました (p=0.001)。治療を受けた高血圧患者と正常な安静時心エコー検査の患者は、健康な対照群と比較して運動時の収縮期長軸機能が低下していました（予備能指数 0.97 対 2.32, p=0.001）。