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Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive

Casper N Bang1, Eva Gerdts, Gerard P Aurigemma

  • 1aDepartment of Medicine, Weill Cornell Medical College, New York, USA bDepartment of Cardiology, The Heart Center, Rigshospitalet, Copenhagen, Denmark cDepartment of Clinical Science, University of Bergen dDepartment of Heart Disease, Haukeland University Hospital, Bergen, Norway eDivision of Cardiology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA fInstitution of Public Health and Clinical Medicine, Umeå University, Medicine Skellefteå, Umeå gDepartment of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden hDepartment of Medicine, Glostrup Hospital, Glostrup, Denmark.

Journal of Hypertension
|July 11, 2013
PubMed

Insights

A new classification of left ventricular hypertrophy (LVH) in hypertensive patients reveals dilated subgroups with impaired left ventricular function. This refined approach identifies distinct patterns of LVH, improving our understanding of cardiac health in hypertension.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Echocardiography

Background:

  • Left ventricular hypertrophy (LVH) is traditionally classified as concentric or eccentric based on relative wall thickness.
  • Hypertension is a major risk factor for LVH, impacting cardiac structure and function.
  • Existing classifications may not fully capture the spectrum of LVH and its functional consequences.

Purpose of the Study:

  • To evaluate left ventricular systolic function using a novel four-group LVH classification.
  • This classification incorporates left ventricular dilatation (high end-diastolic volume index) and concentricity (LVM/EDV ratio).
  • To assess functional differences between LVH subgroups in hypertensive patients.

Main Methods:

  • Analysis of 939 participants from the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiography substudy.
  • Patients with LVH were categorized into four groups: eccentric nondilated, eccentric dilated, concentric nondilated, and concentric dilated.
  • Comparison of echocardiographic parameters and clinical characteristics between LVH groups and those with normal left ventricular mass.

Main Results:

  • At baseline, 12% had eccentric nondilated, 20% eccentric dilated, 29% concentric nondilated, and 14% concentric dilated LVH (25% normal LVM).
  • Concentric dilated LVH showed significantly reduced ejection fraction and increased left ventricular mass index compared to concentric nondilated LVH.
  • Eccentric dilated LVH also demonstrated impaired function compared to eccentric nondilated LVH, with distinct differences observed versus normal LVM groups.

Conclusions:

  • The novel four-group LVH classification effectively identifies subgroups with reduced left ventricular function.
  • Dilated subgroups within both eccentric and concentric LVH classifications exhibit distinct functional impairments.
  • This classification offers a more nuanced understanding of LVH and its impact on cardiac performance in hypertensive individuals.
Abstract

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