Cardiac and Carotid Structure in Arterial Hypertension and in Hypertrophic Cardiomyopathy

Abstract

The aim of this study was to measure intima-media thickness (IMT) of the common carotid artery (CCA) in patients with hypertrophic cardiomyopathy (HCM) and in hypertensive patients with left ventricular hypertrophy (LVH). We studied 73 subjects: 20 normotensive healthy subjects as control group (I); 20 patients with essential hypertension without LVH (II); 20 hypertensives with LVH (III), and 13 normotensive patients with HCM (IV). Each subject underwent a complete echocardiographic and vascular ultrasonographic study in order to assess left ventricular parameters and the IMT at the level of the CCA. Left ventricular mass index (LVMI) was significantly higher in groups III and IV than in groups I and 11(156 ± 18 and 157 ± 31 vs. 94 ± Hand 98 ± 10 g/m², respectively, p < 0.01), while IMT was significantly greater in group III but not in the others [0.88 ± 0.04 vs. 0.61 ± 0.03 (I), 0.64 ± 0.03(11) and 0.61 ± 0.04 (IV) mm, p < 0.01]. The correlation between LVMI and IMT was statistically significant within all the hypertensive patients (r = 0.48, p < 0.01) but not in the HCM group (r = 0.17, p = NS). The hypertensive patients with LVH showed structural alterations (related to hemodynamic and humoral factors) both at cardiac and vascular level while in patients with HCM the cardiac alterations (due to a genetic disorder) were not associated with changes at the level of the large arteries.

Hypertrophic and Hypertensive Hypertrophic Cardiomyopathy—A True Association?

“…32 The hypertensive patients with LVH showed structural alterations (related to hemodynamic and humoral factors) both at cardiac and vascular level, while in patients with HCM the cardiac alterations (due to a genetic disorder) were not associated with changes at the level of the large arteries. 33 Martinez-Diaz et al 34 have studied 3 types of cardiomyopathy to observe the expression and assess the significance of different immunohistochemical markers (muscular actin, CD-31, proliferation cell nuclear antigen (PCNA)-, Ki-67, and markers related with programmed cell death, bcl-2, p-53, and apopDETEC) of 40 cases: 10 each of HHC, HCM, HCM in patients treated with chemotherapy and morphologically ''normal'' hearts. Their findings point to an absence of structural marker expression (actin and CD-31) in cases of hypoxic damage.…”

Impaired Peripheral Vasoconstriction in Response to Alpha-Adrenergic Stimulation in Patients With Idiopathic Hypertrophic Cardiomyopathy

“…large arteries. 17 Endothelial dysfunction assessed based on the changes in either peripheral vascular resistance or the vessel diameter during acetylcholine administration has been used as a sensitive marker of atherosclerosis. 18,19 In our study, we found that in patients with HCM, endothelial-dependent or independent vasodilatation did not differ from that observed in healthy subjects.…”

Vaskuläres Altern, Hypertonie und körperliche Aktivität

“…Die arterielle Hypertonie ist neben dem Alter der am stärksten mit einer Verdickung der IntimaMedia-Dicke einhergehende Risikofaktor [5]. Eine medikamentöse antihypertensive Therapie verzö-gert die jährliche Progression der Intima-MediaDicke bei Patienten mit Hypertonie nach einer Metaanalyse von Wang et al [33] um -0,007 mm gegenüber den Kontrollen.…”