THE HEART IN HYPERTENSION

II

DEVELOPMENTS IN CARDIOVASCULAR MEDICINE

Volume 98

III

The Heart in Hypertension A Tribute to Robert Tarazi (1925-1986)

edited by

M.E. Safar Department of Internal Medicine and Hypertension Research Center, Broussais Hospital, Paris, France

and

F. Fouad-Tarazi Cleveland Clinic Foundation, Cleveland, Ohio, USA

KLUWER ACADEMIC PUBLISHERS DORDRECHT / BOSTON / LONDON

Library of Congress Cataloging-in-Publication Data

The Heart in Hypertension: a tribute to Robert Tarazi (1925-1986)1 edited by M.E. Safar, F. Fouad-Tarazi.

p. cm. - (Developments in cardiovascular medicine; v. 98) Includes bibliographies. 1. Hypertension - Congresses. 2. Hemodynamics - Congresses. 3. Heart - Pathophysiology - Congresses. 4. Tarazi, Robert C. - Congresses. I. Tarazi, Robert C. II. Safar, Michel. III. Fouad-Tarazi, F. IV. Series. [DNLM: 1. Cardiac Output. 2. Coronary Circulation. 3. Heart - physiopathology. 4. Heart Enlargement - drug therapy. 5. Hypertension - complications. WI DE997VME 1 WG 340 H4362] RC685.H8H43 1989 616.1'32 - dc19 DNLMlDLC for Library of Congress

ISBN-13: 978-94-010-6913-7 e-ISBN-13: 978-94-009-0941-0 DOl: 10.1007/ 978-94-009-0941-0

Published by KIuwer Academic Publishers, P.O. Box 17, 3300 AA Dordrecht, The Netherlands

KIuwer Academic Publishers incorporates the publishing programmes of D. Reidel, Martinus Nijhoff, Dr W. Junk and MTP Press.

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printed on acid free paper

All rights reserved

© 1989 by KIuwer Academic Publishers Softcover reprint of the hardcover 1st edition 1989

89-2460

No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner.

Robert C. Tarazi was one of the pioneers of the hemodynamics of Hypertension. He was fond of clinical research and knew the inherent dificulties of this speciality. However, as the great French novelist Albert Camus, he could say on clinical re­search:

'Quand j'habitais ma ville natale, je patientais toujours dans l'hiver parce que je savais qu'en une nuit, une seule nuit froide et pure de fevrier, les amandiers de la vallee des Consuls se couvriraient de fleurs blanches.'

(L'Ete!Les Amandiers, Essais, Edition 'Bibliotheque de la Plei'ade', Paris, Gallimard, 1965, p. 836)

VII

ROBERT CONSTANTIN TARAZI, M.B., B.Ch., M.D. (1925-1986)

Robert Tarazi was born in Cairo in 1925. Following his medical training at Cairo University Hospital, he became head of the Cardiovascular Laboratory at Cairo University Faculty of Medicine in 1960. From his initial affiliation with the Cleveland Clinic in 1965, he became a member of staff and finally Chairman of the Department of Clinical Science in 1978. From 1974-78 he was also Associate Professor of Medicine at the Case Western Reserve University, School of Medicine in Cleveland, Ohio. Throughout his career, Robert Tarazi received high international acclaim for his work and many publications in the field of cardiovascular research and specifically that pertaining to the heart and hypertension.

Table of contents

List of contributors XIII

INTRODUCTION

1. A tribute to Robert C. Tarazi, M.D. (1925-1986) F.M. Bumpus 1

2. The multifaceted aspects of cardiac involvement in hypertension Harriet P. Dustan 5

PART ONE: Cardiac output level and systemic hemodynamics

3. Cardiac output in hypertension: Basic concepts and experimental studies J ean-Franr;ois Liard 15

4. Haemodynamic development F. Magrini 27

5. Systemic hemodynamics and aging Carlo Alicandri and Giulio Muiesan 37

6. The hemodynamics of borderline hypertension Brent M. Egan and Stevo Julius 47

7. Systemic hemodynamics in sustained essential and reno-vascular hypertension Michel E. Safar, Gerard M. London and Yves A. Weiss 67

8. Systemic hemodynamics in primary aldosteronism Emmanuel L. Bravo 79

9. Systemic hemodynamics in patients with pheochromocytoma Michel E. Safar, Yves A. Weiss, Jean L. Cuche and Gerard M. London 87

X Table of contents

10. Systemic hemodynamics in renal parenchymal disease Michel Chaignon and Jacques Guedon 97

11. Hemodynamics in patients with overweight and hypertension Efrain Reisin and Edward D. Frohlich 105

12. Atherosclerotic hypertension: Systolic hypertension and arterial compliance in patients with arteriosclerosis obliterans of the lower limbs Michel E. Safar 123

13. Postmyocardial revascularization hypertension: The role of the heart F.G. Estafanous and Fetnat M. Fouad-Tarazi 135

PART TWO: Cardiac structure and function

14. Cardiac structure and function in animal models and in human hypertension: Basic concepts P.l. Korner 145

15. Volume and cardiac factors in the genesis of mineralocorticoid hypertension in the conscious dog Kaoru Onoyama 165

16. Heart and hypertension: The magnitude of the problem. Electrocardiographic and echocardiographic aspects Edward D. Frohlich and Marc. A. Pfeffer 169

17. Acute volume expansion and pumping function of the heart in sustained essential hypertension Gerard M. London and Michel E. Safar 179

18. Systolic function and inotropism of the heart in borderline and sustained essential hypertension James Conway 189

19. ·Left ventricular diastolic function in hypertension Fetnat M. Fouad-Tarazi 201

20. The right ventricle and the lesser circulation in essential hypertension Maurizio D. Guazzi 209

21. Management of hypertensive patients with cardiac problems Ray W. Gifford, Jr. 221

Table of contents XI

PART THREE: Coronary circulation, left ventricular hypertrophy, and hypertension

22. Coronary circulation, cardiac hypertrophy, and myocardial ischemia: Basic concepts Julien I.E. Hoffman 243

23. Coronary circulation and coronary reserve in the hypertensive heart Pierre Wicker 253

24. Hypertension and coronary atherosclerosis Aram V. Chobanian 271

25. Clinical trials, coronary insufficiency, and large arteries in hypertension Michel E. Safar 281

PART FOUR: Reversion of cardiac hypertrophy

26. Left ventricular hypertrophy and its reversion in hypertension Fetnad M. Fouad-Tarazi 295

27. Regression of cardiac hypert.rophy: Experimental animal model (A review) Subha Sen 301

28. Cardiac structure and function after treatment with adrenergic blocking agents M. Mohsen Ibrahim 309

29. Cardiac structure and function after vasodilating drugs ( dihydralazine-minoxidil) M. Hani Ayobe 325

30. The effect of converting enzyme inhibitors on the hemodynamic profil~ of hypertension Robert J. Cody 333

31. Cardiovascular structure and function after treatment with calcium entry inhibitors in hypertension Roberto Pedrinelli 341

PART FIVE: The heart and reversion of arterial and arteriolar structural changes

32. Baroreceptor mechanisms and the control of the vascular resistance Alberto U. Ferrari, Giuseppe Mancia and Alberto Zanchetti 349

XII Table of contents

33. Structural changes of small resistance vessels in essential hypertension Enrico Agabiti-Rosei and Giulio Muiesan 363

34. Hemodynamic response to exercise in hypertension and its modulation by antihypertensive therapy Per Omvik and Per Lund-Johansen 371

35. Reversion of cardiac, arteriolar and arterial changes following antihypertensive treatment Pierre G. earlier, Nicole S. Smelten and Georges L. Rorive 395

CONCLUSION

36. The heart in hypertension: Mechanical and humoral factors J.I.S. Robertson and W.H. Birkenhiiger 419

List of contributors

Agabiti-Rosei, E., Clinical Medica Generale e Terapia Medica, Universita degli Studi di Brescia, 25100 Brescia, Italy

Alicandri, C.L., Clinical Medica Generale e Terapia Medica, Universita degli Studi di Brescia, 25100 Brescia, Italy

Ayobe, M.H., Physiology Department, Faculty of Medicine, Ain Shams University, Abassia Cairo, Egypt

Birkenhager, W.H., Erasmus University, Rotterdam, The Netherlands Bravo, E.L., Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195

5071, USA Bumpus, F.M., Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH

441955071, USA Carlier, P.G., Laboratoire de Biochemie Generale et Comparee, Universite de L'Etat

a Liege, 17 Place Delcour, B-4000 Liege, Belgium Chaignon, M., Service de Nephrologie, Hopital Foch, 40 rue Worth, 92151 Suresnes,

France Chobanian, A.V., Cardiovascular Institute, Boston University School of Medicine,

Boston, MA 02118, USA Cody, J., Division of Cardiology, The Ohio State University Hospitals, Columbus, OH

43210, USA Conway, J., Department of Cardiovascular Medicine, John Radcliffe Hospital, Head­

ington, Qxford, UK Cuche, J.L., U 228 et Laboratoire de Pharmacologie, Faculte Broussais - Hotel-Dieu,

2 rue de l'Ecole de Medecine, Paris VI, France Dustan, H.P., Birmingham VA Medical Center, 700 South 19th Street, Birmingham,

AL 35233, USA Egan, B.M., Division of Hypertension, Department of Internal Medicine, Medical

College of Wisconsin, Milwaukee, WI 53226, USA Estafanous, F.G., Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH

44195-5071, USA Ferrari, A.U., Centro di Fisiologia Clinica e Ipertensione dell'Universita di Milano,

Via Francesco Sforza 35, 20122 Milano, Italy Fouad-Tarazi, F.M., Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland,

OH 44195-5071, USA

XIV List of contributors

Frohlich, E.D., Alton Ochsner Medical Foundation, 1516 Jefferson Highway, New Orleans, LA 70121, USA

Gifford, R.W., Department of Hypertension and Nephrology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195-5071, USA

Guazzi, M.D., Istituto di Cardiologia, Via Bonfadini 214, 20138 Milano, Italy Guedon, J., Service de Nephrologie, Hopital Foch, 40 rue Worth, 92151 Suresnes,

France Hoffman, J.I.E., Cardiovascular Research Institute, University of California, San

Francisco, CA 94143-0130, USA Ibrahim, M.M., 1, Cardiac Department, Cairo University, Cairo, Egypt Julius, S., Division of Hypertension, Department of Internal Medicine, The University

of Michigan Medical Center, Ann Arbor, Michigan, USA Komer, P.I., Baker Medical Research Institute, Commercial Road, Prahran, Vic.

3181, Australia Liard, J.F., Department of Physiology, The Medical College of Wisconsin, 8701

Watertown Plank Road, Milwaukee, WI 53226, USA London, G.M., Service d'Hemodialyse, Hopital F.H. Manhes, 8 Grande Rue, 91000

Fleury-Merogis, France Lund-Johansen, P., Section of Cardiology, Medical Department, Haukeland Sykehus,

5021 Bergen, Norway Magrini, F., Centro di Fisiologia Clinica e Ipertensione dell'Universita di Milano, Via

Francesco Sforza 35, 20122 Milano, Italy Mancia, G., Centro di Fisiologia Clinica e Ipertensione dell'Universita di Milano, Via

Francesco Sforza 35, 20122 Milano, Italy Muiesan, G., Clinical Medica Generale e Terapia Medica, Universita degli Studi di

Brescia, 25100 Brescia, Italy Omvik, P., Section of Cardiology, Medical Department, Haukeland Sykehus, 5021

Bergen, Norway Onoyama, K., 2nd Department of Internal Medicine, Faculty of Medicine, Kyushu

University, Maidashi 3, Higashi-Ku, Fukuoka City, 812 Japan Pedrinelli, R., Hypertension Unit, Clinica Medica, University of Pisa, 56100 Pisa, Italy Pfeffer, A., Harvard Medical School, Brigham and Women's Hospital, Boston, MA

02118, USA Reisin, E., Alton Ochsner Medical Foundation, 1516 Jefferson Highway, New Or­

leans, LA 70121, USA Rorive, G.L., Laboratoire de Biochemie Generale et Comparee, Universite de L'Etat

a Liege, 17 Place Delcour, B-4000 Liege, Belgium Safar, M.E., Service de Medecine 1 et Centre de Recherche de I'Hypertension Arte­

rielle, Hopital Broussais, 96 rue Didot, 75014 Paris, France Sen, S., Department of Heart and Hypertension Research, Cleveland Clinic Founda­

tion, 9500 Euclid Avenue, Cleveland, OH 44195-5071, USA Smelten, N.S., Laboratoire de Biochemie Generale et Comparee, Universite de

L'Etat a Liege, 17 Place Delcour, B-4000 Liege, Belgium Weiss, Y.A., Service de Medecine Interne, Centre Hospitalier de Meaux, 6 rue St

Fiacre, 77104 Paris, France Wicker, P., Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195-

5071, USA Zanchetti, A., Centro di Fisiologia Clinica e Ipertensione dell'Universita di Milano,

Via Francesco Sforza 35,20122 Milano, Italy