Baroreflex sensitivity correlates with left ventricular morphology and diastolic function in essential hypertension

• Published in: Journal of hypertension Vol. 25; no. 8; p. 1655
• Main Authors: Milan, Alberto, Caserta, Mimma A, Del Colle, Sara, Dematteis, Antonio, Morello, Fulvio, Rabbia, Franco, Mulatero, Paolo, Pandian, Natesa G, Veglio, Franco
• Format: Journal Article
• Language: English
• Published: England 01.08.2007
• Subjects: Adult; Baroreflex - physiology; Blood Pressure Monitoring, Ambulatory; Case-Control Studies; Echocardiography; Female; Heart Ventricles - anatomy & histology; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension - physiopathology; Male; Middle Aged
• ISSN: 0263-6352
• DOI: 10.1097/HJH.0b013e3281ddb0a0

Arterial hypertension is a common cause of cardiac organ damage, inducing morphological and functional modifications. Spontaneous baroreflex sensitivity (BRS) control of the heart rate is a key mechanism of blood pressure homeostasis, and is impaired in patients with hypertension. This study sought to assess the association between BRS and left ventricular morphology and function. We studied 224 hypertensive patients (125 men; aged 47.8 +/- 10.8 years, mean +/- SD) compared with 51 normotensive control subjects (25 men, aged 45.7 +/- 12.5 years). Left ventricular morphology, systolic and diastolic function were evaluated by echocardiography. Spontaneous BRS was measured using the sequence method. BRS was inversely associated with relative wall thickness (R = 0.17; P < 0.0001) and left ventricular mass index (R = 0.03; P = 0.01); in particular, BRS was significantly impaired in patients with concentric left ventricular remodelling (median [interquartile difference] 9.4 [4.1]) and hypertrophy (9.05 [3.9]) compared with the normal left ventricle (12.3 [5]; P < 0.001). BRS showed a significant association with systolic function evaluated by midwall fractional shortening (r = 0.28; P < 0.001), stroke volume (r = 0.27; P < 0.001), stroke work (r = 0.17; P < 0.05), and fractional shortening (r = 0.17; P < 0.05). BRS was significantly decreased in patients with diastolic dysfunction; it was lower in patients with diastolic dysfunction compared with both the control group and hypertensive patients with normal diastolic function. BRS is associated with left ventricular morphology, systolic and diastolic function in hypertensive patients. In particular BRS is impaired in patients with diastolic dysfunction. These findings suggest a role for BRS as a target in arterial hypertension.