Ventricular/vascular coupling and regional arterial dynamics in the chronically hypertensive baboon: correlation with cardiovascular structural adaptation.

Abstract

Ventricular/vascular coupling dynamics and regional hemodynamics of five hypertensive baboons with concentric left ventricular (LV) hypertrophy (mean arterial pressure +/- SD, 148 +/- 16 mm Hg; LV mass/body weight ratio 3.42 +/- 0.8) were compared with five normotensive controls (mean arterial pressure 89 +/- 3 mm Hg; LV mass/body wt ratio 2.73 +/- 0.5) at different mean arterial pressures. Ventricular/vascular dynamics were assessed by aortic input impedance, pulsatile/total power ratio, effective arterial elastance and compliance from a three-element Windkessel "lumped" model of the circulation. Regional arterial dynamics were assessed by pulse-wave velocities and local reflection coefficients. Systemic arterial compliance was similarly decreased with elevated pressure in both groups but was significantly more reduced for the hypertensive group compared with control animals at control (0.49 +/- 0.16 vs. 0.96 +/- 0.09 ml/mm Hg; p less than 0.05) and acutely lowered arterial pressure (0.62 +/- 0.26 vs. 1.41 +/- 0.24 ml/mm Hg, respectively). Changes in compliance were paralleled by differences in effective arterial elastance derived from cineventriculographic pressure-volume ratios. Regional foot-foot and apparent phase pulse-wave velocities were significantly increased for distal aortic segments of the hypertensive animals during elevated pressures compared with controls (cff, 17.5 +/- 7.5 vs. 8.7 +/- 3.0 m/sec; p less than 0.05). Histology of the aorta revealed significant increases in collagen content (microgram/mg dry wt) from proximal to distal aortic segments (27 +/- 2 vs. 38 +/- 6; p less than 0.005) in hypertensive animals but not in controls (27 +/- 2 vs. 32 +/- 6; NS). With pharmacological normalization of systemic arterial pressures, hypertensive baboons developed aortic wave speeds similar to controls but manifested significantly reduced compliance compared with controls. In contrast, with acute elevations of pressure, systemic arterial aortic compliances were similar for both groups, but distal pulse-wave velocities were significantly increased for hypertensive animals compared with controls. We conclude that measures of ventricular/vascular coupling and arterial dynamics are determined by both the level of arterial pressure and the physical characteristics of the cardiovascular system in chronic systemic hypertension and pressure overload ventricular hypertrophy.