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Left ventricular hypertrophy in hypertension: stimuli, patterns, and consequences.
1Department of Medicine, The New York Presbyterian Hospital and Weill Medical College of Cornell University, New York, USA.
Summary
Left ventricular mass is influenced by obesity, diabetes, and hypertension. Reversing left ventricular hypertrophy may improve patient prognosis and reduce cardiovascular events.
Area of Science:
- Cardiology
- Physiology
- Genetics
Background:
- Left ventricular (LV) size correlates with body size in children.
- In adults, LV mass is influenced by obesity, hypertension, cardiac volume load, and myocardial contractility.
- Diabetes, arterial factors, and genetic elements independently associate with increased LV mass.
Purpose of the Study:
- To define geometric patterns of LV adaptation to hypertension.
- To explore associations between LV mass, cardiovascular risk factors, and outcomes.
- To investigate the prognostic implications of LV hypertrophy reversal.
Main Methods:
- Analysis of LV mass and relative wall thickness.
- Classification of LV geometric patterns (concentric hypertrophy, eccentric hypertrophy, concentric remodeling, normal geometry).
- Correlation of LV geometry with clinical factors and cardiovascular event data.
Main Results:
- Four geometric patterns of LV adaptation to hypertension identified.
- Concentric hypertrophy linked to high arterial pressure; eccentric hypertrophy to obesity and volume load.
- Increased LV mass independently predicts cardiovascular events and mortality.
Conclusions:
- LV hypertrophy patterns offer insights into hypertension adaptation.
- Reversal of LV hypertrophy is associated with improved prognosis.
- LV mass and geometry are critical indicators of cardiovascular risk.