Determinants of left ventricular hypertrophy and function in hypertensive patients. An echocardiographic study.

Hypertensive patients present a wide spectrum of echocardiographic alterations. A review of these changes in 74 patients (37 untreated and 37 treated) revealed left ventricular hypertrophy in 43 (58 percent). There was no significant difference between treated and untreated patients in regard to either the prevalence of left ventricular hypertrophy or of its various subtypes [concentric left ventricular hypertrophy in 15 (20.3 percent), asymmetric septal hypertrophy in 16 (21.6 percent), and combined left ventricular hypertrophy and dilation in 12 (16.2 percent)]. None of the patients who showed asymmetric septal hypertrophy had abnormal motion of the mitral valve. Cardiac performance as judged by left ventricular percent shortening was related inversely to end-systolic stress (p less than 0.001) and positively to the ratio of end-systolic pressure/end-systolic volume (an index of myocardial contractility) (p less than 0.01). Multiple regression analysis showed an increased dependence on afterload (end-systolic stress), when left ventricular hypertrophy developed and especially when it was associated with left ventricular dilation.