Left ventricular myocardial performance in normotensive offspring of hypertensive parents

Abstract Offspring of hypertensive parents are at increased risk of developing hypertension. Abnormalities in morphology and function of the left ventricle (LV) may occur very early in the development of essential hypertension and even in the pre-hypertensive period This study was designed to evaluate the influence of genetic predisposition to essential hypertension on LV function by the use of Myocardial Performance Index (MPI), a relatively new parameter of both systolic and diastolic functions. The study included 15 healthy normotensive, non-obese male offspring of hypertensive parents (EH+, mean age 28±5 years). They were compared to 10 aged-matched normotensive subjects without any family history of hypertension (EH-). Ali subjects were sedentary and no-smoker. None of them received any pharmacological treatment. Each subject underwent office blood pressure (BP) measurement and a conventional Doppler Echocardiography including the assessment of MPI defined as the sum of LV isovolumic contraction time and isovolumic relaxation time, divided by LV ejection time. Doppler Tissue Echocardiography (DTE) also was performed at the mitral and tricuspidal anulus, at the lateral site, to evaluate the systolic and diastolic function of both ventricles. LV Relative Wall Thickness (RWT, Le. the ratio between the sum of interventricular septum and posterior wall thickness to LV diameter) was used as a measure of LV remodeling. Office BP was higher in EH+ than in EH-, with a statistical significance for diastolic BP (85±9.2 so vs 71.7±2.9 mmHg; p <0.02). A trend towards an increase in the LV relative wall thickness (RWT) was observed in EH+ compared to EH- (0.37±0.04 vs 0.31±0.02; p=0.05), whilst LV mass was unchanged (84.3±13.8 vs 80.1±6.6 grtm2; p= NS). Systolic and diastolic function of both ventri cles were the same in the two groups. MPI was higher in EH+ than in EH- subjects, although with no statistica I significance (0.48±0.10 vs 0.41 ±0.04; p= NS), mainly due to a statistically signifi¬cant prolongation of isovolumic contraction ti me (61.9±9.2 vs 51.0±10.0; p<0.04). MPI was significantly related to RWT (r=0.44, p<0.05). In conclusion, this study shows in offspring of hypertensive parents: a higher office BP, a trend to a LV concentric remodeling and a different myocardial performance. MPI seems attractive and useful to identify those subjects with genetic predisposition to future hypertension who develop early morphological and functional changes of the cardiovascular system.