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Association between left ventricular remodeling and coronary chronic total occlusion in hypertensive coronary artery

Wujian He1, Qiang Yao1, Duanbin Li2,3

  • 1Department of Cardiology, Hangzhou Red Cross Hospital, No. 208, Huancheng East Road, Hangzhou, 310003, Zhejiang Province, China.

Scientific Reports
|July 7, 2025
PubMed

Insights

Hypertensive left ventricular remodeling, particularly hypertrophy, is linked to a higher risk of coronary chronic total occlusion (CTO) in patients with coronary artery disease (CAD). Further research is needed to confirm this association.

Area of Science:

  • Cardiology
  • Cardiovascular Disease
  • Hypertension Research

Background:

  • Hypertensive left ventricular (LV) remodeling is common in patients with coronary artery disease (CAD).
  • The relationship between LV geometry and the presence of coronary chronic total occlusion (CTO) is not well understood.
  • Anatomical proximity suggests a potential link between LV pathology and coronary artery disease.

Purpose of the Study:

  • To investigate the association between different types of LV remodeling and the incidence of CTO in patients with hypertension and CAD.
  • To determine if specific patterns of LV geometry increase the risk of developing CTO.

Main Methods:

  • Cross-sectional, hypothesis-generating study including 3430 patients with coexisting CAD and hypertension.
  • LV geometry classified by echocardiography into normal, concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH).
  • CTO identified by coronary angiography; logistic regression used to assess the association between LV geometry and CTO.

Main Results:

  • LV remodeling was present in 70.8% of patients; CTO identified in 8.7%.
  • Incidence of CTO increased with LV remodeling severity: 6.1% (normal), 6.9% (CR), 9.9% (CH), and 12.7% (EH).
  • LV remodeling significantly associated with higher CTO risk (OR 1.696), especially CH (OR 1.798) and EH (OR 2.355) compared to normal geometry.

Conclusions:

  • LV remodeling, particularly concentric and eccentric hypertrophy, is associated with an increased risk of CTO in hypertensive patients with CAD.
  • These findings highlight a potential link between hypertensive heart disease and complex coronary artery disease.
  • Further prospective studies are warranted to establish causality and explore underlying mechanisms.

Keywords:
Coronary artery diseaseCoronary chronic total occlusionEchocardiographyHypertensionLeft ventricular remodeling

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