Hypertension and nephrology

[Hypertension and left ventricular hypertrophy]

MATOLTSY András

SEPTEMBER 10, 2016

Hypertension and nephrology - 2016;20(04)

[Left ventricular hypertrophy (LVH) is defined as an increase in the mass of the left ventricle. In addition to the absolute increase in mass, the geometric pattern of LVH also may be important. LVH can be secondary to an increase in wall thickness, an increase in cavity size, or both. LVH as a consequence of hypertension usually presents with an increase in wall thickness. This increase in mass predominantly results from a chronic increase in afterload of LV caused by the hypertension, although there is also a genetic component. A significant increase in the number and/or size of sarcomeres is the main pathologic mechanism, but hypertension may also result in interstitial fibrosis. The estimation of mass is commonly derived from measurements obtained by echocardiography. LVH is associated with increased incidence of systolic and/or diastolic dysfunction, heart failure, myocardial infarction, ventricular arrhythmias, sudden cardiac death, aortic root dilatation, and a cerebrovascular event. The cardiovascular risk is directly related to the degree of mass. The regression of LVH is associated with a reduction in cardiovascular risk and improved cardiac function. Regression of LVH is associated with weight loss, dietary sodium restriction, and use of ACE inhibitors, ARBs, some calcium channel blockers, and some sympatholytic agents.]

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