Asymmetric Ventricular Hypertrophy in Patients with Essential Hypertension

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We attempted to clarify the pathogenesis of asymmetric ventricular hypertrophy in hypertensive patients, especially regarding sympathetic nervous system and renin-angiotensin system. Subjects were divided in 3 groups by echocardiographic findings; 1) 15 patients with non-hypertrophy (NH), 2) 14 patients with symmetric hypertrophy (SH), and 3) 10 patients with asymmetric hypertrophy (ASH).Subjects with ASH showed following features. Age (53.7±1.6yr) was older than NH (43.7±1.4yr) but not different from SH (49.7±2.3yr). Mean arterial pressure (119.0±3.9mmHg) was higher than NH (107.5±1.4mmHg) but not different from SH (122.4±2.8mmHg). End-diastolic and end-systolic dimensions were smaller and ejection fraction was larger than those of NH and SH. Cardiac index (3.90±0.37L/min/M2) was largest among 3 groups. UNE (19.5±3.5μg/day) was lower than SH (31.2±2.5μg/day). PRA (0.44±0.16ng/ml/h) was lower than SH (1.53±0.20ng/ml/h) and NH (1.62±0.28ng/ml/h). Ejection fraction was correlated with UNE (r=0.835) and PRA (r=0.736).We suggest that the heart of hypertensives with ASH is in hyperdynamic state due to the hyperresponsiveness to sympathetic stimuli, although they have a decrease of sympathetic nervous activity, and the renin-volume axis may have no important role on the pathogenesis of ASH.
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