E25 Left atrial systolic function in patients with volume or pressure overload: Effect of isometric exercise

AJH-APRfL 1997-VOL. 10, NO. 4, PART 2

E25

E26

LEFT ATRIAL SYSTOLIC FUNCTION IN PATIENTS

ASYMPTOMATIC CEREBROVASCUIAR DAMAGE IN ESSENTIAL HYPERTENSION IN THE ELDERLY LKobar& M. Igaaa, Y. Jiang, M. Magtsehi,T. Fukuoka,T. Okura, Y. Kitami,K. Hiwada*. 2nd Department of Internal Medicine, Ehirne University, Ehime,Japan.

WITH VOLUME OR PRESSURE OVERLOAD: EFFECT OF ISOMETRIC EXERCISE A.G. Trikas, G.D. Katsimaklis, K.A. Tentolouris, J.K.

Antoniou,K.P. Toutouzas,G.P. Vyssotdis,P.K. Toutouzas. AntihypcrtensionCenter, Dept of Cardiology,Universityof Athens. Although handgrip (FIG) is associated with alterations in transmittalflowvelocities,littleis knownabout its effectupon left atrial (LA) systolic function in idiopathic dilated cardiomyopathy @3C) and hypertension (H). LA volumes, maximal(mitralvalveopening,Vmax),at onset of LA systole (P wave on the electrocardiogram,Vp) and minimal (mitral valve closure, Vmin) were measured echocardiographically prior to and at the end of HG using the biplanearea-length methodin 30 patients(pts) with [DC (age 49*14yrs), 28 pt$ with H (age 51*13yrs) and 30 age and sex-matchednormals (N). LA systolicfunctionwas assessedby LA activeemptying volume [(ACTEV)= Vp-Vmin] and fraction p+

IDC

D.Vmax

-~1

N;

.!2

-=.0001

15.2

D-VP

-5.2

NS

-6.5

<,0025

10.8

9.6 D-Vmin -5.4 NS -7.2 <.0012 1.2 D-ACTEV 2.8 <.05 1.0 NS D-ACTEF 0.2 NS 0.2 <.0001 -.003 NS=nosigniocant, D=ditTerencebetween HG and ba.cclincvalurcs,

~*=comparisonbetweenN and H values, p+=comparison between H and IDC vatues. Conclusions: Thus, wmpensatory responseof LA mechanical

functionto HG in H and N includesa decreasein LA sizeand an augmentationof LA contractileperformance,whilein IDC there is a deterioration of LA booster pump function. KeyWords:

Young Normalkc I Lec II Norma;’d&~ylLac il

[(ACTEF)=

ACTEV/VPl.Resultsare shownin the table: P

Objective: Asymptomaticcerebrovaseulardemsga (ACD) has been shown to be a risk factorfor future stroke. Tha clinicalcharaeteriatiesof ACD in hypertensionin the elderly was evaluated. Method: All study was Prfonnert under hospitalization. One hundredessential hypertensive patients participated. Elderlygroup (n=60, age=60) and middleagadgroup (n=40, ages59) were MSfCheClfor sex, 24-hour systolic blood pressure,and leftventricularmass index (LVMi). As ACD, silentIamar infarctionwas evaluated by MRI. The patienta were divided intothree groups ~rdirg to the number of Iacunae:Nonnel(lacuna=O);Lac I (1 or2); Lac II (>3). Reaulta:

Hypertension,Idiopathicdilatedcardiomyopathy,Left atrial systolicfunction

n

17

13

10

11

17

32

* peO.05vs Normal,f p
E27

E28

NO EFFECT OF AORTIC STIFFNESS ON LEFT VENTRICULAR MASS IN ASYMPTOMATIC SUBJECTS OR PATIENTS WITH SYMPTOMATIC CORONARY ARTERY DISEASE. CD Gatzka, GL Jennings,AM Dart. Baker Medical Research Inatitute,Melbourne,Australia A reducedcompliance,i.e. stiffening,of the central circulationoccursnaturallywith age and advancedatherosclerosis.As pulsewave velocityincreaseswith increasedstiffness, wave reflectionsoccur earlier during systole. It has been postulatedthat such wave reflectionsincrease afterIoad by impedingleft ventricularoutflow.To elucidate the potentialimpactof aortic stiffnesson left ventricularmass, we investigated55 patients (22 women) with eorona~ artery disease (who are knownto have increasedaorticstiffness) and 55 matched controlsubjects (age 63*1 years). Echocardiographicmeasurements of aortic expansion in conjunctionwith non-invasivebrachialartery bloodpressure measurementswere used to determineaorticstiffness. Patients had a higher casual blood pressure (139i3/64*1 vs. 127+2/78*2 mm Hg, p
ROLE OF BASELINE VESSEL SIZE ON IN V2V0 MEASUREMENT OF VASCULAR REACTIVITY. = BH Sung*,S Ciudapati,MS Siddiqui*,MF Wifamr*.Stste Universityof New York, Buffio, NY Relativechangeain venous diameterto vaaoactive substances has been widety used to study vascular reactivityin vivo.However,the influenceof size of blood vessel on vascularreactivityis not clesc. We studied the effeet of veaaelsize on distensibilityof dorsal (DV) and cephalic(CV) veina in 10 healthy subjects using a new technique which provides absolute vessel size. Venous diameter waa measured by an ultraaonography with a 7,5mHztransducerat baaelineand then with cuff intlated to 40 rnmHg. The mean baasline diameter was 1.53 f 0.6rnrnfor DV and 1.5 t 0.7mns for CV. The intlated diameterwas 2.97 t 0,7mmfor DV and 2.91 t 0.7nmsfor CV. The mean increasein diameter waa similarfor DV and CV (1,44 t 0.5 vs 1.41 t 0.4rrun, NS). The percentageincreasein diameter was alao similarfor DV and CV (113 ~ 71 vs 114 i 63°/0,NS). There was a positive correlation between the baaeline diameter and intlated diameter(~O.878, p=O.001) while there was a negative correlation between baseline diasneter and percentage change in diatensibility(r=O.778,F=O.001). There waa no correlation between urrirrtlatedbaseline diameter and absolute change in distensibility(r=O.278, p=NS), conclusions: Dorsaf and cephrdicveina ahowed similardistensibility.Baaelinevessel size effeeta0/0change in distensibility.Unless vasoreactivityis expressed as an absolutechange,it is essentialto study vessels of similar diametersto comparevascularreactivityin vivo. KeyWords: vascularreactivity,venousukraaonography, dorsalvein,cephalicvein, distensibility, correlation

KsyWords:

leftventricularstructure,aorticcompliance, coronaryartery disease