Cardiovascular maladaptation to exercise in young hypertensive patients.
Int J Cardiol
; 232: 280-288, 2017 Apr 01.
Article
em En
| MEDLINE
| ID: mdl-28094132
ABSTRACT
BACKGROUND:
Impairment of the adaptive mechanisms that increase cardiac output during exercise can translate to a reduced functional capacity. We investigated cardiovascular adaptation to exertion in asymptomatic hypertensive patients, aiming to identify the early signs of cardiac and vascular dysfunction. METHODS ANDRESULTS:
We enrolled 54subjects:
30 patients (45.1±11.9years, 19 males) and 24 age-matched healthy controls (44.4±9.6years, 14 males). Speckle-tracking echocardiography (STE) and echo-tracking were performed at rest and during exertion to assess myocardial deformation and arterial stiffness.RESULTS:
E/E' increased from rest to peak exercise more in patients than in controls (peak stage p=0.024). Global longitudinal strain increased significantly from rest to peak stage in controls (p=0.011) whereas it remained unchanged in patients (p=0.777). Left atrial (LA) reservoir was significantly increased throughout the exercise only in controls (p=0.001) whereas it was almost unchanged in patients (p=0.293). LA stiffness was significantly higher in patients than in controls both at rest (p=0.023) and during exercise (p<0.001). Beta index and pulse wave velocity (PWV) increased during exercise in both groups, showing higher values in patients in each step.CONCLUSIONS:
Our study showed a more pronounced maladaptation during exercise, with respect to rest, of the cardiovascular system with impaired cardiac-vessel coupling in hypertensive patients compared to healthy subjects. Exercise echocardiography implemented by STE and echo-tracking is invaluable in the early detection of these cardiovascular abnormalities.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Adaptação Fisiológica
/
Função Ventricular Esquerda
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Tolerância ao Exercício
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Rigidez Vascular
/
Ventrículos do Coração
/
Hipertensão
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Screening_studies
Limite:
Adult
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Female
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Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Itália