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Published on: February 13, 2021
Current Perspectives on Left Ventricular Geometry in Systemic Hypertension
Ahmet Afşin Oktay1, Carl J Lavie1, Richard V Milani1
1Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA.
Insights
Hypertension causes left ventricular remodeling, altering heart geometry and increasing cardiovascular disease risk. Anti-hypertensive therapies can reverse these changes, reducing overall CVD risk.
Area of Science:
- Cardiology
- Hypertension Research
- Cardiovascular Imaging
Background:
- Hypertension (HTN) is a major global health issue and a primary risk factor for cardiovascular disease (CVD) mortality.
- Hemodynamic stress from HTN induces left ventricular (LV) remodeling, leading to abnormal LV geometry (e.g., concentric remodeling, LV hypertrophy).
- LV geometric abnormalities are independent risk factors for CVD and serve as key outcomes in anti-HTN drug trials.
Purpose of the Study:
- To review the intricate relationship between hypertension and left ventricular geometric changes.
- To focus on the diagnostic strategies, epidemiology, pathophysiology, and prognostic impact of these changes.
- To examine the effects of anti-hypertensive therapy on LV geometry and subsequent CVD risk reduction.
Main Methods:
- Literature review of studies investigating hypertension and left ventricular geometry.
- Analysis of diagnostic approaches, including imaging techniques.
- Synthesis of epidemiological data, pathophysiological mechanisms, and prognostic implications.
- Evaluation of clinical trial data on anti-hypertensive treatments and LV remodeling.
Main Results:
- Hypertension is consistently linked to significant alterations in left ventricular geometry.
- LV geometric abnormalities are established independent predictors of cardiovascular events.
- Anti-hypertensive medications demonstrate efficacy in reversing or preventing adverse LV remodeling.
- Therapeutic interventions targeting LV geometry contribute to CVD risk reduction.
Conclusions:
- Hypertension-induced left ventricular geometric changes are critical determinants of cardiovascular risk.
- Accurate diagnosis and monitoring of LV geometry are essential in hypertensive patients.
- Effective anti-hypertensive therapy plays a vital role in mitigating LV remodeling and improving cardiovascular outcomes.
Abstract:
Hypertension (HTN) is a global health problem and a leading risk factor for cardiovascular disease (CVD) morbidity and mortality. The hemodynamic overload from HTN causes left ventricular (LV) remodeling, which usually manifests as distinct alterations in LV geometry, such as concentric remodeling or concentric and eccentric LV hypertrophy (LVH). In addition to being a common target organ response to HTN, LV geometric abnormalities are well-known independent risk factors for CVD. Because of their prognostic implications and quantifiable nature, changes in LV geometric parameters have commonly been included as an outcome in anti-HTN drug trials. The purpose of this paper is to review the relationship between HTN and LV geometric changes with a focus on (1) diagnostic approach, (2) epidemiology, (3) pathophysiology, (4) prognostic effect and (5) LV response to anti-HTN therapy and its impact on CVD risk reduction.
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