Disparate difference in preload reserve between myocardial hypertrophy due to essential hypertension and hypertrophic cardiomyopathy.

To investigate the left ventricular preload reserve in essential hypertensives, the legs-up procedure was performed and the data were compared with those in patients with non-obstructive hypertrophic cardiomyopathy and in normal subjects. Stroke volume index and the following systolic time intervals were measured before and after the legs-up procedure: left ventricular ejection time, pre-ejection period and the ratio of pre-ejection period to left ventricular ejection time (PEP/ET). No changes in blood pressure, heart rate or plasma catecholamine levels were noted before and after the legs-up procedure in all groups. A shortening in the pre-ejection period, a prolongation of ejection time, a decrease in the PEP/ET ratio and an increase in the stroke volume index were observed in essential hypertensives and in normal subjects. However, the changes in these parameters were not observed in patient with hypertrophic cardiomyopathy. The legs-up procedure is known to increase left ventricular end-diastolic volume. These results suggest that myocardial hypertrophy due to essential hypertension preserves the same preload reserve as in normals, but hypertrophic cardiomyopathy does not.