Right ventricular performance in essential hypertension.

Publisher Website
Google Scholar
Abstract
Effects of systemic hypertension on right ventricular (RV) performance have not been investigated. In normal patients [10] were compared to 20 patients with uncomplicated, asymptomatic essential hypertension (defined as cuff diastolic blood pressure .gtoreq. 100 mg Hg) after a complete hemodynamic and RV cineangiographic evaluation. The mean intra-arterial pressure in the normal group was 93 .+-. 11 vs. 120-13 mm Hg in the essential hypertension group (P < 0.01). All right-sided pressures were substantially higher in the hypertensive than in the normal patients (mean right atrial pressure: 2 .+-. 1 mm Hg for normals, 5 .+-. 3 mm Hg for hypertensives, P < 0.01; RV end-diastolic pressure: 3 .+-. 2 mm Hg for normals, 5 .+-. 2 mm Hg for hypertensives, P < 0.05; mean pulmonary artery pressure: 12 .+-. 3 mm Hg for normals, 17 .+-. 5 mm Hg for hypertensives, P < 0.01; mean pulmonary capillary wedge pressure: 6 .+-. 1 mm Hg for normals, 9 .+-. 3 mm Hg for hypertensives, P < 0.01). Cardiac index in normal and hypertensive patients was nearly identical (2.93 .+-. 0.80/min/m2 in normals, 3.11 .+-. 0.67 min/m2 in hypertensives, NS [not significant]). A markedly lower cineangiographic RV ejection fraction was present in the hypertensive compared to the normal patients (68 .+-. 6% vs. 59 .+-. 7%, P < 0.01). The lower RV ejection fraction was due to the proportionately greater increase in the RV end-systolic volume index (22 .+-. 5 ml/m2 for normals, 34 .+-. 8 ml/m2 for hypertensives, P < 0.01) than in the end-diastolic volume index (69 .+-. 13 ml/m2 for normals, 82 .+-. 16 ml/m2 for hypertensives, P < 0.04) in the hypertensive patients. Hypertensive patients have higher right-sided pressures than normals. RV performance in essential hypertension may be characterized by a lower RV ejection fraction than in normal subjects.