Structural remodeling of large arteries in patients with hypertensive myocardiopathy is correlated to the ventricular geometry and renal dysfunction

Abstract

Objectives: To study structural and functional parameters of large arteries in hypertensive subjects (sbjs) with different patterns of hypertensive myocardiopathy. Material and Methods: 45 hypertensive sbjs (PA > 140/90 mmHg or under treatment) were evaluated and hypertensive myocardiopathy was defined by left ventricular hypertrophy (LVH) (LVMi >125 g/m²) and/or systolic dysfunction (SD) (FE < 0.50) at the echocardiogram and divided into2 groups: 1) LVH without SD, 16 sbjs; 2) LVH with DS, 18 sbjs. Data was compared to 11 hypertensive sbjs without LVH or SD. Arterial parameters (intimal-medial thickness-IMT, internaldiameter, distensibility) were assessed at the right carotid by a high-resolution “echo-tracking”equipment and the aortic stiffness was assessed through carotid-femoral pulse wave velocity(PWV) by Complior method. Results: The patients of the group LVH with SD showed a larger carotid diameter (8,02 ± 0,88mm) and a larger IMT (0,88 ± 0,21mm) than those from the control group (7,04 ± 0,73mm e 0,68 ± 0,13mm)(p < 0.01). The sbjs from the LVH without SDgroup showed no differences among the other groups. The PWV and the carotid distensibility were similar among the 3 groups. At multivariate analysis, the IMT was significatively correlated to the LVMi (r = 0,44, p < 0,005), while the carotid diameter was correlated to age and serumcreatinine (r = 0.54). Conclusion: In hypertensive subjects with LVH and systolic dysfunction there is a structural remodeling in large arteries. This remodeling is correlated to ventricular geometry and renal failure, without alterations in vascular function.