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Updated: Aug 29, 2025

A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
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A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure

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Changes of left ventricular remodeling due to increased afterload in patients with essential hypertension

Mareomi Hamada1, Akiyoshi Ogimoto1, Takashi Otani2

  • 1Division of Cardiology, Uwajima City Hospital, 1-1, Goten-machi, Uwajima, Ehime 798-8510, Japan.

International Journal of Cardiology
|September 5, 2022
PubMed

Insights

Afterload mismatch, a condition where the heart works harder than it should, does not occur in early essential hypertension (EHT) without left ventricular hypertrophy (LVH). It develops in advanced EHT with LVH and heart failure due to depleted preload reserve.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Heart Failure Studies

Background:

  • Essential hypertension (EHT) and its impact on left ventricular hypertrophy (LVH) require further clarification regarding afterload mismatch.
  • The transition point of LVH between preserved and reduced systolic function in hypertensive patients is not well understood.

Purpose of the Study:

  • To investigate the occurrence of afterload mismatch in the initial stages of essential hypertension.
  • To clarify the relationship between left ventricular hypertrophy and systolic function in hypertensive individuals.

Main Methods:

  • Studied 140 EHT patients (3 groups: no LVH, LVH, LVH with heart failure) and 45 controls.
  • Measured electrocardiographic and echocardiographic parameters, including relative wall thickness (RWT), LV mass (LVM) index, and peak systolic wall stress (PSWS).

Main Results:

  • Preserved systolic function with increased PSWS in EHT without LVH.
  • LVH advanced with preserved systolic function in one group; negative T-waves indicated issues in advanced stages.
  • Afterload mismatch was identified in advanced EHT with heart failure (group III) due to preload reserve exhaustion, with an LVM index boundary around 180 g/m².

Conclusions:

  • Afterload mismatch is absent in early essential hypertension without LVH.
  • Afterload mismatch occurs in advanced EHT with LVH and heart failure, linked to the exhaustion of preload reserve.
Abstract

Keywords:
Afterload mismatchHeart failureHypertensionLeft ventricular hypertrophyPreloadWall stress

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