Left ventricular performance at rest and during peak exercise in never-treated hypertensive female - an assessment with radionuclide ventriculography

Aim: The aim of this study was to investigate left ventricular performance and exercise tolerance in never-treated female hypertensive patients. Materials and Methods: Seventeen female patients with newly established, uncomplicated essential hypertension (aged 25 to 57 years) were evaluated with rest-stress radionuclide gated ventriculography, and were compared to 23 age-matched normotensive female volunteers. Results: Mean blood pressure was significantly higher in patients at rest and during exercise than in controls (121±13 vs. 89±7 mm Hg, and 143±11 vs. 122±9 mm Hg, respectively, p<0.001). At peak exercise patients achieved a similar workload and exercise duration. Increase in heart rate during exercise was similar in patients and controls (from 72±8 to 142±16 vs. 75±10 to 138±14 beats/min, respectively). At rest, no significant difference in end-diastolic (EDV), end-systolic left ventricular volume (ESV) and cardiac output (CO) was observed between two groups. During stress, EDV and CO were significantly higher in patients (91±13 vs. 68±11 ml/m2; and 6.8±2.2 vs. 4.7±1.6 l/min/m2, respectively, p<0.01), while ESV was similar in both groups. Ejection fraction (EF) at rest and stress did not differ significantly (54±10 vs. 55±8%, and 70±10 vs. 66±8%, respectively), but % rise in EF during exercise was significantly higher in patients. At rest and during exercise, there were no significant difference in peak ejection rate (PER) and time to PER (TPER) between patients and controls. Patients had similar peak filling rate (PFR) at rest (2.88±0.79 vs. 2.76±0.76 EDV/s) and during exercise (5.85±1.86 vs. 6.21±1.97 EDV/s), in addition to nonsignificant difference in time to PFR (at rest 143±62 vs. 146±42 ms at rest, and 97±20 vs. 91±19 ms during exercise). Conclusion: Female patients with newly diagnosed, never-treated hypertension have preserved maximal exercise performance, systolic function and diastolic function, but they have significant enlargement of EDV and elevated cardiac output during exercise