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Relation of obesity, high sodium intake, and eccentric left ventricular hypertrophy to left ventricular exercise dysfunction in essential hypertension

Relation of obesity, high sodium intake, and eccentric left ventricular hypertrophy to left ventricular exercise dysfunction in essential hypertension

American Journal of Medicine 88(5): 477-485

PURPOSE: To elucidate determinants of abnormal left ventricular functional responses to exercise in hypertensive patients. PATIENTS AND METHODS: One hundred twenty-seven patients with uncomplicated essential hypertension were studied by rest and exercise radionuclide angiography and by echocardiography at rest. RESULTS: The 24 patients with subnormal left ventricular ejection fraction at peak exercise (less than 54%) were similar in age and rest and exercise blood pressures to the 103 with normal exercise ejection fraction, but were more obese (p < 0.005) and had greater left ventricular mass (p < 0.03) and internal dimensions (p < 0.001). The parallel increase in left ventricular chamber size and mass (eccentric hypertrophy) in the group of patients with exercise dysfunction was associated with higher resting end-systolic wall stress (p < 0.001) and abnormal increases of end-systolic left ventricular volume from rest to peak exercise (p < 0.001). Multivariate analysis revealed that exericise left ventricular dysfunction was independently associated with higher left ventricular mass (p < 0.0005), end-systolic wall stress (p < 0.001), dietary sodium intake (p < 0.01), and body mass index (p < 0.03). CONCLUSION: Among patients with uncomplicated essential hypertension, abnormal functional responses to exercise are strongly associated with eccentric ventricular hypertrophy, obesity, and high sodium intake.

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Accession: 007737667

Download citation: RISBibTeXText

PMID: 2140011

DOI: 10.1016/0002-9343(90)90426-e

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