Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

Abstract

The occurrence of ventricular hypertrophy undoubtedly represents an important marker of increased risk for cardiovascular events; therefore, the importance of identifying the patterns of hypertrophy in patients with hypertension is widely justified 1,2 . A recent study by Mensah et al 3 reported that measurement of the left ventricular mass on echocardiography proved to be better for predicting the evolutional process of hypertension as compared with other variables, such as systolic blood pressure, diastolic blood pressure, and hypertension staging 4 . Left ventricular hypertrophy is no longer considered an adaptive process that compensates the pressure imposed on the heart and has been identified as an independent and significant risk factor for sudden death, acute myocardial infarction, and congestive heart failure 4,5 . In cardiac hypertrophy, anomalous collagenous proteins and other types of contractile proteins (myosin with different functional properties) are produced. These myosins show a lower activity of the ATPase enzyme and a lower velocity of power generation. Likewise the formation of anomalous collagenous proteins, changes in contractile proteins also occur. Concomitantly, sarcomeres and fibroblasts proliferate and become hyperplastic. These adaptations aim to maintain the cardiac contractile capacity to compensate the pressure load imposed on the heart 6 . The cardiac adaptive process is not always beneficial for functioning of the heart and causes alteration in myocardial fibers, in the cardiac capacity to respond to adrenergic stimuli, in the left ventricular diastolic function, in the coronary artery flow, and finally in the contractile function 6 . Left ventricular hypertrophy causes important derangements in coronary artery flow. If hypertrophy is mild, the increase in coronary circulation may proportionally accompany the increase in left ventricular mass through vascular neoformation or use of mechanisms of flow reserve. In the cases of significant increase in ventricular mass, generation of new vessels and capillaries is disproportional to the

Left ventricular geometric patterns in newly presenting nigerian hypertensives: An echocardiographic study

“…In this study twenty eight percent (28%) of the hypertensive subjects had normal geometry while 72% had various altered geometric while 86% of the controls had normal geometry. Previous studies [ 20 - 23 ] carried out in Brazil, United States and Europe showed different frequencies for various LV geometric patterns. Ethnic differences and environmental factors might play an important role in the different geometric patterns.…”

“…Adaptation of the left ventricle to systemic hypertension is complex and it is characterized by functional and structural changes in the left ventricle. The old concept that the heart responds to systemic hypertension by developing concentric or eccentric hypertrophy have been challenged by recent studies[ 4 , 6 , 20 ]. Hypertension is now known to be associated with a wider spectrum of LV geometric patterns [ 3 , 4 ].…”

Features of heart remodeling in patients with moderate bronchial asthma in combination with arterial hypertension

“…В представленном нами исследовании у больных АГ в сочетании с БА наблюдаются бόльшие значения ИММЛЖ по сравнению с таковыми у лиц с АГ без сопутствующей патологии бронхиального дерева. Из доступной нам литературы известно, что имеются немногочисленные источники, указывающие на наличие у больных АГ в сочетании с БА бόльших значений массы миокарда ЛЖ по сравнению с таковыми у лиц с АГ без сопутствующей патологии бронхиального дерева [5,6,11,12]. Ведущей причиной развития гипертрофии ЛЖ у части больных АГ служит стабильность хронически повышенной нагрузки на миокард ЛЖ [9].…”

“…В исследовании Барсукова А. В. (2005) и его иностранных коллег при оценке структуры ЛЖ у пациентов с сочетанной патологией выявлена концентрическая гипертрофия ЛЖ, однако у пациентов с АГ в сочетании с БОЗ показана бóльшая степень концентричности по сравнению с изолированной АГ, что также подтверждается данными наших наблюдений [6,11].…”

Left ventricular cardiac geometry and ambulatory blood pressure in children

“…Studies have found that ABPM values are more accurate and strongly correlated with LVH when compared to clinic blood pressure . Evidence suggests that blood pressure parameters measured from 24‐hour ABPM may serve as predictors of specific cardiac geometries . One pediatric study demonstrated differences in ABPM parameters by cardiac geometry; however, limited epidemiological evidence is available regarding the determinants of LV geometry in the pediatric population.…”