Hashimoto Y, Tamaki H, Hosaka T, Maezawa H
Jpn Heart J. 1984 Nov;25(6):1029-45. doi: 10.1536/ihj.25.1029.
For clarifying the onset mechanism of essential hypertension, the hemodynamics in 9 mildly hypertensive men, mean age of 39.8 +/- 10.7 (mean +/- SD), was compared with 7 normotensive men, mean age of 39.8 +/- 10.7, by means of exercise echocardiography, and the effects of indenolol (administered 30 mg/day for 7 days orally to both groups) were studied. The interventricular septum and the left ventricular posterior wall were thickened in the mild hypertensives. No significant differences between the both groups were shown in the cardiac performance at rest and the cardiac index during exercise. The total peripheral vascular resistance was higher in the mild hypertensives than the normotensives during exercise. However, during exercise, the normotensives showed significant increases in the left ventricular end-diastolic dimension (LVDd) and the stroke index (SI); these changes were not significant in the mild hypertensives. After administration of indenolol, the significant increases in LVDd and SI during exercise were observed in the mild hypertensives. This study suggests that mild hypertensives with cardiac hypertrophy display a diminished Frank-Starling effect during exercise which may be attributed to the decreased left ventricular compliance due to cardiac hypertrophy and elevated afterload. Indenolol improved the Frank-Starling effect, which decreased in the mild hypertensives.
为了阐明原发性高血压的发病机制，通过运动超声心动图比较了9名轻度高血压男性（平均年龄39.8±10.7岁，均值±标准差）和7名血压正常男性（平均年龄39.8±10.7岁）的血流动力学，并研究了吲哚洛尔（两组均口服30mg/天，共7天）的作用。轻度高血压患者的室间隔和左心室后壁增厚。两组在静息时的心脏功能和运动期间的心指数无显著差异。运动期间，轻度高血压患者的总外周血管阻力高于血压正常者。然而，运动期间，血压正常者的左心室舒张末期内径（LVDd）和每搏指数（SI）显著增加；这些变化在轻度高血压患者中不显著。服用吲哚洛尔后，轻度高血压患者运动期间的LVDd和SI显著增加。本研究表明，伴有心脏肥大的轻度高血压患者在运动期间表现出减弱的Frank-Starling效应，这可能归因于心脏肥大导致的左心室顺应性降低和后负荷增加。吲哚洛尔改善了轻度高血压患者降低的Frank-Starling效应。
