The Relation between Left Ventricular Geometric Patterns and Left Ventricular Midwall Mechanics in Hypertensive Patients

Abstract

LV geometric patterns. The LV geometry changes followed by the alteration of myocardial contractility. And patients with different LV geometry patterns tend to have different prognoses (2-5). In some studies, LV ejection fraction (EF) and LV fractional shortening (FS) have been measured at the endocardium, reflecting chamber dynamics but not necessarily providing a direct measurement of myocardial fiber shortening (6, 7). Such a method might overestimate myocardial function in the presence of LV hypertrophy.The midwall fractional shortening (mFS) and mFS/endsystolic wall stress relation is more accurate and more appropriate for estimating the myocardial contractility (8,9). Accordingly, we assessed the midwall left ventricular mechanics in normotensive and hypertensive subjects in order to

Noninvasive Evaluation of the Time Course of Change in Cardiac Function in Spontaneously Hypertensive Rats by Echocardiography

“…In hypertensive patients, LV geometry can be classified into four patterns on the basis of LV mass index and RWT (11), and these patterns have been shown to be closely related to the LV function and to patients' prognosis (18,19). In the present study, eccentric LV hypertrophy was apparent at the first measurement time point in the SHR, and after 6 weeks, RWT increased progressively, a geometric pattern conforming to concentric hypertrophy.…”

Is Echo‐Determined Left Ventricular Geometry Associated with Ventricular Filling and Midwall Shortening in Hypertensive Ventricular Hypertrophy?

“…Early diagnosis of LV systolic dysfunction by MFS is relevant because hypertensive patients with low MFS are at greater risk of fatal or nonfatal cardiovascular events, since MFS is an independent predictor of cardiovascular risk in hypertensive patients 21 . MFS may be decreased in concentric remodeling, eccentric hypertrophy, and concentric hypertrophy, but patients affected by concentric hypertrophy have less contractility 24 . This increase in mortality is independent of traditional cardiovascular risk factors and, at least partially, of increased LV mass.…”

“…21 MFS may be decreased in concentric remodeling, eccentric hypertrophy, and concentric hypertrophy, but patients affected by concentric hypertro-phy have less contractility. 24 This increase in mortality is independent of traditional cardiovascular risk factors and, at least partially, of increased LV mass. Increased LV mass occurs more often in patients with concentric LVH, who have an high risk of fatal cardiovascular events, but a parallel trend was also observed in patients with eccentric LVH.…”

Losartan Prevents Heart Fibrosis Induced by Long-Term Intensive Exercise in an Animal Model

“…Furthermore, exercised animals developed myocardial fibrosis and showed alterations in ECM protein synthesis in both atria and in the right ventricle, indicating that these changes could promote alterations in heart functionality [6]. Therefore, ameliorating and preventing myocardial fibrosis would be very important in the management of future cardiovascular events [24], [25]. ANGII is a powerful stimulus for progressive cardiac remodeling and plays a significant role in promoting myocardial fibrosis [26], [27].…”