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Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension

Ganau, Antonello and Devereux, Richard B. and Roman, Mary J. and De Simone, Giovanni and Pickering, Thomas G. and Saba, Pier Sergio and Vargiu, Paolo and Simongini, Isabella and Laragh, John H. (1992) Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. Journal of the American College of Cardiology, Vol. 19 (7), p. 1550-1558. ISSN 0735-1097. eISSN 1558-3597. Article.

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DOI: 10.1016/0735-1097(92)90617-V


The spectrum of left ventricular geometric adaptation to hypertension was investigated in 165 patients with untreated essential hypertension and 125 age- and gender-matched normal adults studied by two-dimensional and M-mode echocardiography. Among hypertensive patients, left ventricular mass index and relative wall thickness were normal in 52%, whereas 13% had increased relative wall thickness with normal ventricular mass (“concentric remodeling”), 27% had increased mass with normal relative wall thickness (eccentric hypertrophy) and only 8% had “typical” hypertensive concentric hypertrophy (increase in both variables).
Systemic hemodynamics paralleled ventricular geometry, with the highest peripheral resistance in the groups with concentric remodeling and hypertrophy, whereas cardiac index was supernormal in those with eccentric hypertrophy and low normal in patients with concentric remodeling. The left ventricular shortaxis/long-axis ratio was positively related to stroke volume (r = 0.45, p < 0.001), with cavity shape most elliptic in patients with concentric remodeling and most spheric in those with eccentric hypertrophy. Normality of left ventricular mass in concentric remodeling appeared to reflect offsetting by volume “underload” of the effects of pressure overload, whereas eccentric hypertrophy was associated with concomitant pressure and volume overload.
Thus, arterial hypertension is associated with a spectrum of cardiac geometric adaptation matched to systemic hemodynamics and ventricular load. Concentric left ventricular remodeling and eccentric hypertrophy are more common than the typical pattern of concentric hypertrophy in untreated hypertensive patients.

Item Type:Article
ID Code:10755
Uncontrolled Keywords:Hypertension, left ventricular geometric adaptation, spectrum, M-mode echocardiography
Divisions:001 Università di Sassari > 03 Istituti > Clinica medica generale e terapia medica
Copyright Holders:© 1992 by the American College of Cardiology
Deposited On:04 Feb 2015 15:55

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