RELATION OF LEFT-VENTRICULAR HYPERTROPHY, AFTERLOAD, AND CONTRACTILITY TO LEFT-VENTRICULAR PERFORMANCE IN GOLDBLATT HYPERTENSION

被引：16
作者：
DESIMONE, G [1 ]
DEVEREUX, RB [1 ]
VOLPE, M [1 ]
CAMARGO, MJF [1 ]
WALLERSON, DC [1 ]
LARAGH, JH [1 ]
机构：
[1] CORNELL UNIV,MED CTR,NEW YORK HOSP,DEPT MED,DIV CARDIOL,BOX 222,525 E 68TH ST,NEW YORK,NY 10021
来源：
AMERICAN JOURNAL OF HYPERTENSION | 1992年 / 5卷 / 05期
关键词：
LEFT VENTRICULAR HYPERTROPHY; AFTERLOAD; CONTRACTILITY; PLASMA RENIN ACTIVITY; ATRIAL NATRIURETIC FACTOR;
D O I：
10.1093/ajh/5.5.292
中图分类号：
R6 [外科学];
学科分类号：
1002 ; 100210 ;
摘要：
To analyze the determinants of left ventricular (LV) performance (myocardial afterload, chamber size, mass, and contractility) in Goldblatt hypertension, 19 anesthetized one-kidney, one-clip (1K1C) and 28 two-kidney, one-clip (2K1C) male Wistar rats were studied 58 to 62 days after clipping, together with 19 sham-operated and 13 normal rats (controls), by M-mode echocardiography using necropsy-validated methods of measurement. The LV fractional shortening was inversely related to end-systolic stress in all groups (r = -0.89 to -0.95, all P < .00001): 7 2K1C (25%) and 9 1K1C (47%) had fractional shortening above the upper confidence limit in control animals. Both 1K1C and 2K1C with high LV performance had severe hypertension, inadequate LV hypertrophy, with resultant high wall stress (both P < .005), increased LV chamber dimension (P < .005 and P < .05, respectively) and high afterload-corrected fractional shortening (both P > .001); 2K1C also had high plasma renin activity and atrial natriuretic factor levels (both P < .01). Rats with normal LV performance exhibited mild hypertension, adequate LV hypertrophy (normalizing wall stress), and normal LV chamber size and afterload-corrected fractional shortening. Thus, 8 1/2 weeks after clipping, adequate LV hypertrophy allows maintenance of normal LV function by normalizing myocardial afterload in a majority of rats with Goldblatt hypertension, whereas increased LV contractility (and possibly use of preload reserve in 1K1C) maintains normal LV function in the presence of inadequate LV hypertrophy and elevated wall stress, in a substantial minority of rats that developed more severe Goldblatt hypertension.
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页码：292 / 301
页数：10
相关论文
共 46 条
[1]  
Desimone G., Lorenzo L., Moccia D., Et al., Hemodynamic hypertrophied left ventricular patterns in systemic hypertension, Am J Cardiol, 60, pp. 1317-1321, (1987)
[2]  
Ganau A., Devereux R.B., Pickering T.G., Et al., Relation of left ventricular hemodynamic load and contractile per- formace to left ventricular mass in hypertension, Circulation, 81, pp. 25-36, (1990)
[3]  
Ganau A., Devereux R.B., Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension, J am Coll Cardiol
[4]  
Lutas E.M., Devereux R.B., Reis G., Increased cardiac performance in mild essential hypertension: Left ventricular mechanics, Hypertension, 7, pp. 979-988, (1985)
[5]  
Hartford M., Wikstrand J., Wallentin I., Et al., Left ventricular wall stress and systolic function in untreated primary hypertension, Hypertension, 7, pp. 97-104, (1985)
[6]  
De Simone G., Di Lorenzo L., Costantino G., Et al., Supernormal contractility in primary hypertension without left ventricular hypertrophy, Hypertension, 11, pp. 457-463, (1988)
[7]  
De Simone G., Devereux R.B., Camargo M., In vivo left ventricular anatomy in rats with 2-kidney, 1-clip and 1-kidney, 1-clip renovascular hypertension, J Hypertens, (1992)
[8]  
Brunner H.R., Kirshman J.D., Sealey J.E., Et al., Hypertension of renal origin: Evidence for two different mechanisms, Science, 174, pp. 1344-1346, (1971)
[9]  
Gavras H., Brunner H.R., Vaughan E.D., Et al., Angiotensinsodium interaction in blood pressure maintenance of renal hypertensive and normotensive rats, Science, 180, pp. 1369-1372, (1973)
[10]  
Gavras H., Brunner H.R., Thurston H., Et al., Reciprocation of renin dependency with sodium volume dependency in renal hypertension, Science, 188, pp. 1316-1317, (1975)
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