RELATION OF OBESITY, HIGH SODIUM-INTAKE, AND ECCENTRIC LEFT-VENTRICULAR HYPERTROPHY TO LEFT-VENTRICULAR EXERCISE DYSFUNCTION IN ESSENTIAL-HYPERTENSION

purpose: To elucidate determinants of abnormal left ventricular functional responses to exercise in hypertensive patients. patients and methods: One hundred twenty-seven patients with uncomplicated essential hypertension were studied by rest and exercise radionuclide angiography and by echocardiography at rest. results: The 24 patients with subnormal left ventricular ejection fraction at peak exercise (less than 54%) were similar in age and rest and exercise blood pressures to the 103 with normal exercise ejection fraction, but were more obese (p <0.005) and had greater left ventricular mass (p <0.03) and internal dimensions (p <0.001). The parallel increase in left ventricular chamber size and mass (eccentric hypertrophy) in the group of patients with exercise dysfunction was associated with higher resting end-systolic wall stress (p <0.001) and abnormal increases of end-systolic left ventricular volume from rest to peak exercise (p <0.001). Multivariate analysis revealed that exercise left ventricular dysfunction was independently associated with higher left ventricular mass (p <0.005), end-systolic wall stress (p <0.001), dietary sodium intake (p <0.01), and body mass index (p <0.03). conclusion: Among patients with uncomplicated essential hypertension, abnormal functional responses to exercise are strongly associated with eccentric ventricular hypertrophy, obesity, and high sodium intake. © 1990.