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ABSTRACT. In patients with arterial hypertension the development of concentric hypertrophy of the left ventricle (LV) is known to be a subclinical target organ damage and is associated with higher incidence of cardiovascular events and higher total cardiovascular risk. Until the major aspect of LV remodeling, that is concentric hypertrophy, the LV geometry passes through intermediate phases, as concentric remodeling or eccentric remodeling. Many studies affirm the prognostic importance of the LV concentric hypertrophy and of the increased LV mass in hypertensive patients. The aim of this study was to investigate the prevalence of the LV structural changes in asymptomatic patients with essential arterial hypertension. We evaluated 237 adults with uncomplicated essential hypertension, and 106 normotensive adults were the control group. Criteria for inclusion in the study were: LV ejection fraction >50% and the presence of sinus rhythm. We used M-mode and 2D transthoracic echocardiography for the measurement of LV and of left atrium (LA) dimensions. The LV geometry was classified as normal, concentric remodeling, concentric hypertrophy or eccentric hypertrophy depending on the LV wall’s relative thickness and mass index. In hypertensive patients cardiac remodeling parameters are significantly altered (relative wall thickness, LV mass and mass index, left atrial diameter and volume). LV geometry analysis showed that 73.4% of hypertensives had a form of LV remodeling (34.5% concentric hypertrophy, 27.5% eccentric hypertrophy, 11.4% concentric remodeling) and only 26.6% had normal LV geometry. These results are important considering the high risk for non-fatal and fatal cardiovascular events hanging over some apparently healthy people. pp. 14–23

Keywords: hypertension; hypertrophy; echocardiography; remodeling; prevalence

Rodica Radu
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Grigore T. Popa University of Medicine, Romania
Catalina Arsenescu Georgescu
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Grigore T. Popa University of Medicine, Romania

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