2026-05-15T14:07:05Z https://www.peertechzpublications.org/oai-pmh

oai:www.peertechzpublications.org:10.17352/ach.000007 2016-04-15 PTZ.ACH:VOL2

Correlation of Cardiac Sympathetic Nervous System Dysfunction with Diastolic Left Ventricular Dysfunction in Patients with Controlled Hypertension Elsayed Abo-salem Mouhamad Abdallah Mohamed Effat Said AlsidawiMyron Gerson<p><strong>Introduction</strong>: Sympathetic nervous system activity is increased in patients with systemic hypertension. Angiotensin converting enzyme inhibitors can effectively control hypertension without a reflex sympathetic stimulation. However, limited data are available about the role of sympathetic dysfunction in the&nbsp;&nbsp; pathophysiology of diastolic dysfunction among patients with controlled hypertension receiving angiotensin converting enzyme inhibitors.</p><p><strong>Methods:</strong> Twenty four non-diabetic patients with controlled hypertension on angiotensin converting enzyme inhibitors without heart failure and not currently on β-blocker therapy were included in the study. Patients were divided into 2 groups based on diastolic function as defined by echocardiography, group A with diastolic dysfunction (10 subjects) and group B without diastolic dysfunction (14 subjects). Patients underwent ambulatory blood pressure monitoring for assessment of nocturnal blood pressure dip and 123I metaiodobenzylguanidine (123I-MIBG) imaging to determine heart to mediastinum ratio. Plasma norepinephrine levels were measured.</p><p><strong>Result:</strong> Patients with diastolic dysfunction had a higher level of plasma norepinephrine (0.46 vs 0.26 ng/ml, p=0.01) as compared to patients with normal diastolic function. There was no statistically significant difference in the early or late heart to mediastinum ratio (p=0.5) or the wash-out rate (p=0.9) among the two groups. There was no correlation between plasma norepinephrine and 123I-MIBG uptake. There was a statistically significant inverse correlation between E/A ratio and the log of plasma norepinephrine level (r= - 0.43, P=0.03).</p><p><strong>Conclusion</strong>: Localized cardiac autonomic dysfunction is not significantly worse in grade I diastolic dysfunction, compared to normal</p> Archives of Clinical Hypertension - Peertechz Publications 2016-04-15 Research Article https://doi.org/10.17352/ach.000007 en Copyright © Elsayed Abo-salem et al.