Circulation, Vol 62, 116-126, Copyright © 1980 by American Heart Association
M Takahashi, S Sasayama, C Kawai and H Kotoura
To assess the contractile state of the hypertrophied ventricle induced by
long-standing systemic hypertension in 22 patients, we used
echocardiography for the measurement of the ventricular diameter and
posterior wall thickness, together with simultaneous recording of brachial
arterial pressure. Meridional wall stress (WSt) was used for the expression
of the force per unit cross-sectional area. The WSt- diameter relation
obtained during dynamic responses to acute pressure reduction by
nitroprusside infusion was compared with the same relation obtained in 10
normal subjects (posterior wall thickness averaged 0.7 cm [range 0.6-0.9
cm]) over a range of matched systolic pressure induced by methoxamine
administration. In 15 patients in whom end- diastolic wall thickness
increased to 1.1 cm (range 1.0-1.2 cm), the linear WSt-diameter relation at
end-systole did not differ from the control group, indicating a normal
level of inotropic state. In the seven patients with an end-diastolic wall
thickness of 1.3 cm or more, the end-systolic WSt-diameter relation was
clearly shifted to the right and had a less steep slope. These findings
indicate that in advanced left ventricular hypertrophy induced by pressure
overload, myocardial contractility may be depressed.
ARTICLES
Contractile performance of the hypertrophied ventricle in patients with systemic hypertension
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