COMMON CAROTID-ARTERY STIFFNESS AND PATTERNS OF LEFT-VENTRICULAR HYPERTROPHY IN HYPERTENSIVE PATIENTS

The aim of this study was to determine the relationship between the lumen diameter and function of the common carotid artery, a vessel representative of the capacitance portion of the circulation, and the different patterns of left ventricular hypertrophy in uncomplicated essential hyper tensive patients. Carotid luminal diastolic cross-sectional area, distensibility, and compliance were derived from measurements by a high-definition echotracking system. Left ventricular dimensions were from echocardiography. The 86 hypertensive patients included 31 who had never been treated (group 1), 31 in whom treatment had been stopped for at least 2 weeks (group 2), and 24 treated patients (group 3). In multivariate analysis of the population as a whole, the following relations were statistically independent of age, blood pressure, gender, and group: Left ventricular end-diastolic volume index was positively correlated to carotid luminal cross-sectional area (r=.46, P<.0001) and compliance (r=.47, P<.0001); left ventricular mean wall thickness and mass-volume ratio were negatively correlated to distensibility (r =-.68, P<.0001; r=-.46, P<.0001, respectively) and compliance (r=-.40, P<.0001; r=-.37; P<.001, respectively); and left ventricular mass index was positively correlated to luminal cross-sectional area (r=.23, P<.02) and negatively to distensibility (r=-.26, P<.01). These results indicate that geometric and functional changes in the common carotid artery accompany geometric changes in the left ventricle. More specifically, they suggest that a reduction in distensibility paralleled cardiac concentric hypertrophy and remodeling, whereas an increase in arterial volume paralleled increased left ventricular cavity size.