P5.13 CHANGES IN VENTRICULO-ARTERIAL COUPLING IN PATIENTS WITH HYPERTENSION AND TYPE-2-DIABETES AFTER A PERIOD OF INTENSIFIED ANTIHYPERTENSIVE TREATMENT

DOI

10.1016/j.artres.2013.10.162How to use a DOI?

Abstract

Objective: To examine changes in ventriculo-arterial coupling (VAC) and left ventricular systolic function (LVF_SYS) after a period of intensified antihypertensive treatment in patients with hypertension and type-2-diabetes.

Methods: Patients were categorized as controlled- (CH), uncontrolled- (UH) or resistant (RH) hypertensives based on ambulatory blood pressures (BPs) and number of antihypertensive agents. Central BPs were estimated using radial applanation tonometry and a generalized transfer function. LVF_SYS was evaluated using ejection fraction (EF) and S’ (echocardiography). VAC was estimated as the ratio of effective arterial elastance (E_A) to end-systolic elastance (E_ES).

Results: 100 Patients were included (CH N=34, UH N=32, RH N=34). Median [interquartile ranges] follow up time was 6 [5;8] months.

At follow up patients with UH and RH had a significantly higher E_A and E_A/E_ES compared to patients with CH. Despite a significant reduction in central BPs of 6/4 and 8/3 mmHg there was a non-significant increase in E_A/E_ES in patients with UH and RH respectively. E_ES was significantly reduced in all hypertension groups (figure 1).

On average EF and S’ was below 55% and 8 cm/s in all hypertension groups. In patients with RH EF and S’ were further reduced from 48 [39;53] % to 42 [34;47] % (P=0.01) and 7 [6;8] to 7 [5;7] cm/s (P=0.01).

Conclusion: VAC and LVF_SYS did not improve despite a reduction in central BPs. Instead E_ES deteriorated in all hypertension groups. We speculate whether this is due to a reduction in myocardial perfusion or a gradual progression of diabetic cardiomyopathy.

Open Access

This is an open access article distributed under the CC BY-NC license.

TY  - JOUR
AU  - T.K. Soender
AU  - L. van Bortel
AU  - T. de Backer
PY  - 2013
DA  - 2013/11/11
TI  - P5.13 CHANGES IN VENTRICULO-ARTERIAL COUPLING IN PATIENTS WITH HYPERTENSION AND TYPE-2-DIABETES AFTER A PERIOD OF INTENSIFIED ANTIHYPERTENSIVE TREATMENT
JO  - Artery Research
SP  - 147
EP  - 147
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.162
DO  - 10.1016/j.artres.2013.10.162
ID  - Soender2013
ER  -