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Hypertensive Left Ventricular Hypertrophy Regression: Does It Matter?
Journal article   Open access   Peer reviewed

Hypertensive Left Ventricular Hypertrophy Regression: Does It Matter?

Wadih Nadour and Robert W. W. Biederman
Current hypertension reviews, v 4(4), pp 275-288
01 Jan 2008
DOI: https://doi.org/10.2174/157340208786241309
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1038/s41598-022-10483-7View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Cardiovascular System & Cardiology Life Sciences & Biomedicine Peripheral Vascular Disease Science & Technology
Hypertensive left ventricular hypertrophy (LVH) has a devastating pathologic, clinical and socioeconomic impact. The recognition of the consequences of hypertension, the incidence of LVH and its subsequent long-term manifestations on our population continues to increase. Escalating amounts of medical resources are devoted towards the understanding of hypertension and its treatment, all aimed in some part at decreasing, either directly or indirectly, LVH. LVH is further complicated by relatively inexpensive and inexact clinical tools to detect its presence, namely EKG. While echo-cardiography has improved the recognition of LVH, more recent data demonstrate that cardiovascular MRI (CMR) is the 'gold standard' for its quantitation. In this review article, we aim to delineate the pathology of hypertrophy at the level of the myocyte and interstitium, incorporating new data that suggests the interstitium plays a heretofore unknown, but increasing role in the pathogenesis of LVH. We will review the pathophysiology of LVH as it relates to morbidity and mortality while reviewing the current tools for detecting LVH. Most importantly, we will review the studies that answer the question of whether LVH does matter. Specifically, we will review classical studies that, while demonstrating LVH's importance, failed to show that LVH regression led to substantial improvement in clinical outcome, while such recent studies, such as the LIFE study, have pointed to the primacy of LVH, not only as a surrogate marker for cardiovascular morbidity and mortality, but suggesting that its regression offers major impact into cardiovascular disease with potential long-term socioeconomic benefits. Herein, the impact of myocardial performance using advanced technologies such as CMR is illustrated as an ideal tool for understanding more complex pathophysiologic perturbations. Finally, and most intriguing, is a threshold of LVH in g/m(2) that we suggest as a potential pharmacologic goal in order to institute a clinically meaningful impact of LVH regression.

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1 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Web of Science research areas
Peripheral Vascular Disease
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