low leftventricular ejection fraction and hypertension

[yangzijian2008]

I am an intensivist. One of patient present with low leftventricular ejection fraction of 30% and severe hypertension with systolic pressure of  250 mmHg. If blood pressure were properly controlled,   leftventricular ejection fraction would increse to higher level. How to evaluate the ejection fraction correctly?  How to exclude the effects of hypertension

[ohiofill]

TELL HIM TO START TAKING COQ10 FOR HIS PROBLEM.

[kenkeith]

The EF is almost always a measure of myocardial contractility and degree of viability that measures contractility and that can be accomplished with (FS) fractional shortening.  FS is particularily sensitive to afterload.  An increase in systemic BP or an increase in myocardial stiffness will therefore reduce FS%...not to the exclusion of other factors.

Fractional shortening equals the difference between end systolic dimension from end diastole divided by systole.  For instance: my FS was 6.2 cm - 5.2 cm = 1; 1 divided by 6.2 = 16%. At the time my EF 29%.  

Consider range for FS is 18 to 42%.  Above 30% is equivilant to an EF greater 55% where normal EF is greater than 55%... 26 to 30% representing a mild decrease in the EF.    

There is an assumption made here high bp causes a dilated left ventricle due to overcompensation.  If the low EF is due to hardening and thickening of the heart walls and/or damaged heart tissues a correction in bp pressure, etc may not do much to increase the EF, but medication can slow or stop the process of heart failure.

Your question seems to imply a negative correlation of high blood pressure to a low EF and what is the calculus?.  I don't beleive there is a calculation...too many other negative and positive variables.  But as stated you may want to contact a professional.  Thanks for the quewstion.

[anacyde]

Ejection fraction is what it is.  To improve it (if it will improve), the blood pressure definitely needs to come down.  Beta blockers are just one of the medications that they would typically use in this situation, they may also prescribe an ACE-I and a diuretic.  Definitely try to post this in the professional forum, we're not doctors over here.

[erijon]

You may need to post this on the Medical Experts board as there are no doctors in this forum. I could be wrong, but I don't think anyone here is qualified to answer these questions as a professional. Keep in mind that any answers you get in this forum will be from community members, not medical professionals. I know this is over my head.

Good Luck,

Jon