[The multifactorial genesis of left ventricle remodeling in patients with essential arterial hypertension]

Area of Science:

• Cardiology
• Hypertension Research
• Vascular Biology

Background:

• Essential hypertension (EH) is a prevalent cardiovascular condition.
• Understanding the mechanisms of left ventricular remodeling (LVH) in EH is crucial for patient management.
• Previous studies suggest complex interactions between hemodynamic and hormonal factors in EH progression.

Purpose of the Study:

• To investigate the multifactorial genesis of left ventricular remodeling (LVH) in patients with essential hypertension (EH).
• To explore the associations between hemodynamic, hormonal, and vascular parameters with LVH in different stages of EH.

Main Methods:

• Echocardiography, radionuclide, and radioimmune methods were used in 122 patients with EH.
• Carotid-femoral pulse wave velocity (PWV) was measured in 43 patients.
• Hemodynamic parameters (cardiac index, total peripheral resistance), hormonal levels (renin, aldosterone), and LV geometry were assessed.

Main Results:

• Stage I EH showed increased cardiac index, which decreased with blood pressure stabilization, accompanied by rising total peripheral resistance.
• Elevated aldosterone levels were observed across all EH stages; renin levels varied by stage.
• Concentric LV hypertrophy was the predominant remodeling pattern (62.8%), followed by eccentric LVH (22.1%).
• Increased PWV was noted in all patients, more pronounced in stage III EH, with significant associations with various hemodynamic, hormonal, and structural parameters.

Conclusions:

• The development of LVH and LV remodeling in EH is multifactorial.
• Both hemodynamic and hormonal influences contribute to volume-dependent and pressure-dependent LVH.
• Pulse wave velocity is a valuable indicator reflecting the severity of EH and its impact on cardiac and vascular structures.