Left ventricular diastolic function in physiologic and pathologic hypertrophy

Abstract

Doppler echocardiographic parameters of LV diastolic function can be of diagnostic importance for discrimination between pathologic and physiologic LV hypertrophy.

Left ventricular filling abnormalities and obesity-associated hypertension: relationship with overproduction of circulating transforming growth factor β1

“…A significant increase in TGFb1 values and LVM/h 2.7 and a higher prevalence of subjects with left ventricular hypertrophy were found in the subset of hypertensives with diastolic dysfunction in comparison with patients with normal diastolic function. According to literature data [37][38][39][40] and to higher prevalence of LVH found in our hypertensives with altered diastolic function, TGFb1 overproduction might be able to affect diastolic function through an altered left ventricular geometry. Surprisingly, in our study, multivariate analysis indicated an independent role of TGFb1 in the occurence of alteration in left ventricular filling.…”

“…This hypothesis might be supported by the statement that, with the fibrotic remodelling process, an increase in the stiffness of left ventricular myocardium can lead to an early impairment of the diastolic function. 40 In addition, some clinical implications arise from the results of our study. In particular, an early recognition of altered left ventricular filling in the presence of the normal left ventricular systolic function may be beneficial in single subjects as well as in a strategy for general health care.…”

Regression of left ventricular hypertrophy is a key goal of hypertension management

“…This is commonly called physiologic LVH, as it is reversible and not associated with adverse effects [11,16]. Differentiating between physiologic LVH and pathologic LVH (such as LVH from hypertension) is of clinical importance.…”

“…Schannwell et al [16] recently studied 49 athletes with LVH due to endurance training, 49 patients with LVH due to hypertension, and 26 untrained healthy control subjects by Doppler echocardiography. There were comparable values for LV muscle mass and muscle mass index in the trained athletes (99 ± 10 g) and hypertensive patients (95 ± 11 g), both being much higher than those of the control group (52 ± 7 g; P < 0.01 for athletes and hypertensives).…”

“…LVH in the athlete group was accompanied by a normal LV diastolic filling pattern. However, in patients with hypertension, diastolic dysfunction consisting of a delayed relaxation with a decrease in maximal early velocity of diastolic filling and a compensatory increase of the maximal late velocity of diastolic filling was demonstrated [16]. Therefore, the dynamic parameters of LV diastole from Doppler echocardiography are of diagnostic importance in discriminating between pathologic and physiologic LVH.…”