The aim of the study was to evaluate hypertension treatment effects on mechanical efficiency of the cardiovascular system and cardiac reverse remodeling in hypertensive patients. This is an observational prospective study, consecutive hypertension patients. Left ventricle mass index measured by Devereux 2D method and diastolic function following the Guidelines from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Left ventricular end systolic elastance (Ees) was measured by Guarracino calculator, the effective arterial elastance (Ea) and ventricular-arterial coupling (VAC) measured by Sunagawa et al. single beat method adapted by Chen et al. in human ventricles. The sample was analyzed in quartiles (Q) according to VAC. Follow-up 2 years. In total, 288 patients, mean age 56.3 ± 12.5 years and 168 patients (58.3%) males. VAC increased from 0.303 ± 0.07 to 0.54 ± 0.25 (p < 0.005) in Q1 mainly due to a reduction in Ees from 5.25 ± 2.3 to 3.68 ± 0.25 mmHg/ml (p < 0.01), while Ea increased from 1.5 ± 0.53 to 1.64 ± 0.56 mmHg/ml (p = NS). The frequency of LVH was reduced from 31.9 to 10.8% in Q1 (p < 0.025). The frequency of normal diastolic function increased from 75 to 94.6% (p < 0.01) in Q1, from 78.7 to 100% in Q2 (p < 0.005), from 87.1 to 100% (p < 0.025) in Q3 and from 88.7 to 100% (0,025) in Q4. Patients with the worst ventricular-arterial uncoupling were the most benefited from hypertension treatment. Regression of left ventricular hypertrophy was observed only in the group of patients with the worst ventricular-arterial uncoupling, while improvement in diastolic function was demonstrated in all quartiles of patients.
Keywords: Cardiac reverse remodeling; Cardiovascular mechanical efficiency; Diastolic dysfunction; Hypertension treatment; Ventricular arterial coupling.
© 2022. The Author(s), under exclusive licence to The Japanese Society of Hypertension.