Regression of LVH after anti-hypertensive treatment in patients with mild to moderate hypertension
Journal Title: Medpulse International Journal of Medicine - Year 2019, Vol 9, Issue 3
Abstract
Hypertension remains the most common predisposing factor for cardiac failure, and the presence of electrocardiographic evidence of left ventricular hypertrophy magnifies this risk. Echocardiography provides a more accurate and sensitive means of detecting left ventricular hypertrophy than electrocardiography. This diagnostic technique therefore permits the identification of more subtle cardiac involvement, which nevertheless has prognostic importance. Echocardiography has the added advantage of providing information on the structure and function of the heart. A sustained reduction in arterial pressure leads to regression of left ventricular hypertrophy, with maintenance of or improvement in left ventricular function. Although improvement in clinical outcomes has been associated with echocardiographic evidence of regression of left ventricular hypertrophy, there is no solid evidence of an independent benefit beyond blood-pressure control in terms of morbidity or mortality. Left ventricular adaptation to hypertension can present with any of the geometric patterns. The hemodynamic predominance between pressure and volume overload plays an important role in the determination and development of various LV geometric patterns. Concentric remodeling tends to occur early in hypertension due to pressure overload but the left ventricular mass is normal while eccentric hypertrophy is due to volume overload with increased left ventricular mass which cannot be picked up by electrocardiography. The present study observed echocardiography is the best tool to detect LVH as target organ damage in hypertension as compared to surface ECG. Our study showed that in concentric remodeling, chamber dimensions were smaller with reduced stroke volume, cardiac output and increased heart rate compared to the other geometric patterns. The present study results suggest that this procedure could significantly improve cardiovascular risk stratification in those patients with multiple risk factors, with evidence of early detection of target organ damage by detecting LVH by Echocardiography. It requires further more follow ups to comment on the morbidity and mortality benefits with control of hypertension and degree of regression of LVH in hypertensive patients.
Authors and Affiliations
Dinesh Patil, Deepali Vidhate, Archna Bhate
Keywords
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- EP ID EP516739
- DOI 10.26611/1021933
- Views 72
- Downloads 0
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