What question did this study set out to answer?

To determine whether concentric left ventricular remodeling and hypertrophy are driven by pressure overload rather than volume overload in individuals with volume-dependent primary hypertension.

August 10, 2021American Journal of Hypertension

Hemodynamic and Functional Correlates of Concentric vs. Eccentric LVH in a Community-Based Sample With Prevalent Volume-Dependent Hypertension

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Why the study?

It was unclear whether concentric LV remodeling beyond hypertrophy in volume-dependent primary hypertension represents the impact of pressure overload rather than volume overload.

Population

709 individuals of African ancestry from a community with prevalent volume-dependent primary hypertension

Comparison

Concentric vs eccentric LVH or remodeling

Design

Community-based observational study

Authors

HBHamza BelloApple (Israel)GNGavin R. NortonGeneral / Preventive / Lipids VPVernice R. PetersonUniversity of the Witwatersrand

Discussion

Member takes

Implication

May indicate volume overload drives concentric LVH in hypertension; hypothesis-generating for relative wall thickness effects on systolic function.

Key Points

To determine whether concentric left ventricular remodeling and hypertrophy are driven by pressure overload rather than volume overload in individuals with volume-dependent primary hypertension.
Assessed 709 participants of African ancestry from a community-based sample with prevalent volume-dependent primary hypertension.
Measured central arterial pressures, aortic outflow velocity, and aortic diameters using echocardiography, alongside 24-hour ambulatory blood pressure monitoring.
Evaluated independent relationships between left ventricular geometry (mass index and relative wall thickness) and hemodynamic parameters such as stroke volume, systemic vascular resistance, and arterial compliance.
Both concentric and eccentric left ventricular hypertrophy were linked to comparable increases in end-diastolic volume, stroke volume, and blood pressures (P < 0.0001 for both), but neither was associated with elevated systemic vascular resistance or impedance.
Relative wall thickness, but not left ventricular mass index, independently and inversely correlated with myocardial systolic function, including midwall shortening and s' velocity (P < 0.05 to <0.005).
Significant reductions in left ventricular systolic function occurred selectively in concentric hypertrophy (P < 0.05), whereas systolic performance remained preserved in eccentric hypertrophy.

Structured PICO

Population

709 individuals of African ancestry from a community-based sample with prevalent volume-dependent primary hypertension

Outcome

Factors associated with concentric left ventricular hypertrophy (LVH) or remodeling, including hemodynamic and functional echocardiographic parameterssurrogate

In volume-dependent primary hypertension, concentric LVH is driven by volume-dependent flow increases similarly to eccentric LVH, but concentric remodeling is uniquely associated with decreased systolic function.

Cite This Study

Bello et al. (2021) studied this question.

synapsesocial.com/papers/6a8c79917b1ef46d2ffdf41e https://doi.org/10.1093/ajh/hpab128

Topics

Hypertension management

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Implication

May indicate volume overload drives concentric LVH in hypertension; hypothesis-generating for relative wall thickness effects on systolic function.

Hemodynamic and Functional Correlates of Concentric vs. Eccentric LVH in a Community-Based Sample With Prevalent Volume-Dependent Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Hemodynamic and Functional Correlates of Concentric vs. Eccentric LVH in a Community-Based Sample With Prevalent Volume-Dependent Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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