Correlation of Coronary Artery Disease and Left Ventricular Hypertrophy

Abstract

Ischemic heart disease (IHD) is the leading cause of death worldwide, and it is defined as an imbalance between myocardial oxygen supply and demand. Coronary artery disease (CAD) and left ventricular hypertrophy (LVH) are two common causes of IHD that independently result in myocardial ischemia. CAD decreases myocardial blood and oxygen supply whereas LVH increases myocardial oxygen demand. The coexistence of both CAD and LVH results in a significant increase in oxygen demand while simultaneously lowering oxygen supply.Since hypertension is a shared predisposing condition for both CAD and LVH, the left ventricular (LV) mass on noninvasive echocardiography can reflect on the severity of coronary artery stenosis. In clinical practice, it can help physicians decide whether to perform invasive cardiac catheterization to visualize the extent of the coronary block. Although, both CAD and LVH are directly proportional to mortality risk, the addition of eccentric LVH can further increase morbidity and mortality due to myocardial infarction. Therefore, the latest management of both the acute and chronic phases of CAD places an increased emphasis on controlling the predisposing factors to prevent or reverse LVH. For example, angiotensin-converting enzyme inhibitors and diuretics reduce LV mass by lowering the cardiac preload and afterload. This article aims to investigate the deleterious effects of the collaboration between CAD and LVH, establish a causal relationship, and explore the new prevention and management strategies.

Ectasia and slow flow phenomena of coronary artery related to apical hypertrophic cardiomyopathy

“…However, in cases of severe hypertrophy, this increase in size is not proportional and can result in an increase in cardiac demand, potentially leading to ischemia. [11][12][13] In these cases, the underlying mechanisms leading to the increase in coronary artery size may involve enhanced chronic stimulation of endothelium-derived relaxing factor perfusion pressure, circulating neurohormones, and local growth factors. 12 In our patient, diffuse dilatation of the coronary arteries without stenosis was observed.…”

“…Studies have demonstrated that in cases of mild to moderate left ventricular hypertrophy, there is a proportional increase in the size of the coronary vessels. However, in cases of severe hypertrophy, this increase in size is not proportional and can result in an increase in cardiac demand, potentially leading to ischemia 11–13 . In these cases, the underlying mechanisms leading to the increase in coronary artery size may involve enhanced chronic stimulation of endothelium‐derived relaxing factor perfusion pressure, circulating neurohormones, and local growth factors 12 …”

MRASin coronary artery disease—Unchartered territory

“…LVH can, independently of CAD, result in myocardial ischemia, which can further increase morbidity and mortality due to myocardial infarction. 59 This is supported by the fact that the gain-of-function variant, p.Gly23Val, identified in patients with Noonan syndrome is accompanied by cardiac hypertrophy and a 40-fold F I G U R E 3 Muscle rat sarcoma virus (MRAS) and associated traits. MRAS variants are associated with a variety of common genetic conditions, including coronary artery disease, Noonan syndrome, or cardiac hypertrophy.…”

From Iron Metabolism to Ferroptosis: Pathologic Changes in Coronary Heart Disease

“…CHD, especially MI, leads to CM damage or death due to ischemia and hypoxia, resulting in a localized cardiac function deficit. Under prolonged stimulation, peripheral CMs gradually hypertrophy to compensate for partial cardiac function [ 110 , 111 ]. The early stage of MH is a beneficial compensatory response for the organism, but its compensatory capacity is limited.…”