Relation between Left Ventricular Geometric Alteration and Extracardiac Target Organ Damage in Hypertensive Patients.

Abstract

To study the relation between left ventricular geometric alteration and extracardiac target organ damage in hypertensive patients. A retrospective study of 298 patients with essential hypertension was performed.Left ventricular mass index (LVMI) and relative wall thickness (RWT) were calculated using echocardiographic data. Patients were divided into four groups based on their left ventricular geometric pattern as determined using LVMI and RWT. Each of the four left ventricular geometric patterns was associated with a different degree of extracardiac organ damage. In multivariate analysis, LVMI and RWT showed strong, significant correlation to retinal changes and increases in serum creatinine levels, respectively. Alteration of left ventricular geometry resulted in an increase in the degree of extracardiac target organ damage.

Wave Intensity Analysis Can Identify Eccentric Cardiac Hypertrophy in Hypertensive Patients With Varied Left Ventricular Configurations

“…Westerhof et al 14 held the view that patients with concentric remodeling and concentric hypertrophy have higher mortality than those with eccentric hypertrophy and normal morphologic characteristics. However, several studies demonstrated that eccentric hypertrophy is more highly related to deleterious cardiovascular outcomes 15 – 17 and was associated strongly with decreased systolic and diastolic function 18 . We hypothesized that some wave intensity parameters in eccentric hypertrophy were significantly different than those found in other geometric patterns.…”

Left Ventricular Mass Index: A Predictor of Morbidity and Mortality in Essential Hypertension

“…Target organ damage was found to be higher among patients with increased LVMI as compared to those with normal LVMI, with p<0.01 for retinopathy. Ding Y et al 16 showed that there is extremely high prevalence of retinopathy in patients with increased left ventricular mass index (p<0. 05).…”

Left Ventricular Hypertrophy Is More Prevalent in Type B than Type A Aortic Dissection

“…The classification of LV geometry (normal, concentric remodeling, eccentric hypertrophy, and CH) based on LVMI and RWT has been widely used in population studies. 5 , 6 , 9) Of the four types of LV geometry, a previous study showed that CH presented with the highest SBP and was considered to be related to hypertension. 5 , 6) CH is induced by pressure overload, 17) such as hypertension, aortic stenosis, hypertrophic cardiomyopathy, and storage diseases, among others, while LVH was classically considered to be the result of hypertension.…”

“…We focused on only CH as an indicator of LVH since it was known to be the most strongly associated with hypertension out of the four types of LV geometry. 5 , 6) Patients’ history, including systolic blood pressure (SBP) just before admission without the intravenous administration of an antihypertensive drug, and factors associated with atherosclerosis, were compared between those with types A or B AD. In addition, the following data regarding LV geometry as measured by echocardiography were compared between such patients: days from the onset of AD to evaluations with echocardiography, left ventricular end-diastolic dimension (LVDd), left ventricular end-systolic dimension (LVDs), left ventricular ejection fraction (LVEF), values of LVMI in total, those in males (mLVMI), those in females (fLVMI), the value of RWT, the prevalence of increased LVMI, the prevalence of increased RWT, and the prevalence of CH.…”