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Physiologic considerations in left ventricular hypertrophy.

E D Frohlich

    The American Journal of Medicine
    |September 26, 1983
    PubMed
    Summary
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    Left ventricular hypertrophy, a response to high blood pressure, involves structural heart changes and impaired contraction. Factors like age, sex, race, and disease influence its development and regression with treatment.

    Area of Science:

    • Cardiology
    • Hypertension Research
    • Cardiovascular Physiology

    Background:

    • Left ventricular hypertrophy (LVH) is a key indicator of hypertensive vascular disease.
    • Increased cardiac mass in hypertension is a structural adaptation to elevated afterload.
    • LVH can precede left ventricular failure and contribute to cardiovascular events.

    Purpose of the Study:

    • To review hemodynamic evidence for the sequence of events in LVH development.
    • To identify pathophysiological and clinical factors contributing to increased cardiac mass beyond pressure overload.
    • To explore factors influencing the regression of cardiac mass with antihypertensive therapy.

    Main Methods:

    • Review of hemodynamic evidence.
    • Analysis of pathophysiological factors (e.g., pressor mechanisms).

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  • Consideration of clinical factors (e.g., age, sex, race, comorbidities).

    • Main Results:

    • Hypertension-induced LVH involves initial hyperfunction followed by sustained structural adaptation and impaired contraction.
    • Factors beyond pressure overload, including patient demographics and comorbidities, influence LVH development.
    • These factors partially explain the regression of cardiac mass observed with antihypertensive treatment.

    Conclusions:

    • Understanding the transduction of mechanical stimuli into biochemical events is crucial for fully comprehending LVH development and regression.
    • Further research is needed to elucidate the molecular mechanisms underlying cardiac adaptation to pressure overload.
    • Targeting these mechanisms may lead to more effective treatments for reversing LVH.