New perspectives on left ventricular hypertrophy: Anatomy, physiology, and significance

Abstract

The advent of echocardiography has added an important and sensitive tool for assessment of left ventricular hypertrophy (increased left ventricular mass). Recent echocardiographic studies in large population‐based samples suggest an epidemic of left ventricular hypertrophy. Preliminary data suggesting important prognostic importance for such left ventricular hypertrophy (independent of standard risk factors) has fueled interest in the development, determinants, and other features of the hypertrophy. Hemodynamic and neurohumoral factors are the most prominent stimuli to adaptive (physiologic) myocardial hypertrophy, which can progress to maladaptive (pathologic) hypertrophy. The overall blood pressure experience, overweight, the cardiovascular response to recurrent psychosocial stress and physical activity level are four important correlates and potential determinants of left ventricular mass in various urban‐suburban populations. Determination of the relative contributions and interrelations of these and other factors (such as heredity) to various forms of left ventricular hypertrophy found in various demographic groups warrants intensive investigation.

Assessment of Risk Factors for Cardiovascular Complications in Patients with Chronic Kidney Disease (CKD) Stage III-V before Dialysis

“…13,38 Indeed, left ventricular growth itself is a strong, independent predictor of lower survival rates, cardiovascular mortality, arrhythmia and sudden death. 39 Importantly, left ventricular growth is modifiable through treatment of hypertension and anaemia. 40 LVH rose proportionally to GFR decline reaching a value >50% in stage V. In the present study, we found LVH in 44.4% of patients in stage V by echocardiography and a slightly lower percentage (40.7%) by ECG.…”

The velocity of cardiac sarcomere shortening: mechanisms and implications

“…In turn, the velocity of sarcomere length change (V SL ) is determined by ‘Hill’s’ hyperbolic function and this allows for a balance of force between the billions of sarcomere that are connected in series in the LV wall (ter Keurs et al, 2010). Regulation of this hyperbolic function is achieved by both variation of the maximal V SL , which depends on the MHC composition and by the maximal isometric stress that can be generated in response to inotropic and trophic stimuli (Ricciardi et al, 1986; ter Keurs et al, 1989). Power output, equalling the product of V SL and the developed stress, is consequently regulated by these factors as well (McDonald, 2011).…”