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Extracardiac organ damage in essential hypertensives with left ventricular concentric remodelling

C Cuspidi1, V Giudici, S Meani

  • 1Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy. cesare.cuspidi@unimib.it

Journal of Human Hypertension
|December 5, 2009
PubMed

Insights

Updated criteria reveal left ventricular concentric remodeling (LVCR) is linked to organ damage. This cardiac phenotype, identified using newer guidelines, signifies increased cardiovascular risk in hypertensive patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Criteria Evaluation

Background:

  • Current definitions of left ventricular concentric remodeling (LVCR) rely on outdated guidelines, potentially limiting clinical and prognostic assessments.
  • Essential hypertension is a major cardiovascular risk factor, necessitating accurate identification of associated cardiac phenotypes and organ damage.

Purpose of the Study:

  • To investigate the association between LVCR, defined by updated criteria, and subclinical extracardiac organ damage (OD) in hypertensive patients.
  • To evaluate the prognostic significance of LVCR as a marker of target organ damage in individuals with normal left ventricular mass.

Main Methods:

  • Analysis of 1906 hypertensive patients (treated and untreated) with normal echocardiographic left ventricular mass index (LVMI).
  • LVCR was defined using updated criteria (relative wall thickness >42).
  • Prevalence of subclinical OD (carotid plaque, carotid intima-media thickening, retinopathy, microalbuminuria) was compared between patients with and without LVCR using multivariate analysis.

Main Results:

  • LVCR was identified in 29.8% of patients (568/1906).
  • Patients with LVCR showed significantly higher rates of carotid plaque, carotid intima-media thickening, retinopathy, and microalbuminuria compared to those with normal geometry.
  • LVCR demonstrated an independent association with carotid intima-media thickness and microalbuminuria.

Conclusions:

  • Updated diagnostic criteria for LVCR identify a phenotype strongly associated with subclinical vascular and renal damage.
  • LVCR, identified using contemporary definitions, serves as a valuable marker of target organ damage.
  • LVCR assessment offers additional value for cardiovascular risk stratification in hypertensive patients with normal left ventricular mass.

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