Differences in left-ventricular geometric remodeling induced by hypertension and obesity

• Published in: International Journal of Obesity Vol. 25; pp. S3 - S4
• Main Authors: Bastac, D, Vujisic-Tesic, B, Joksimovic, Z, Djokovic, B
• Format: Journal Article
• Language: English
• Published: 01.10.2001
• ISSN: 0307-0565

Left ventricular hypertrophy is a strong predictor of cardiovascular morbidity and mortality. Increased afterload in hypertension induces concentric hypertrophy and obesity, by increasing preload, induces eccentric left ventricular hypertrophy (LVH). SixtY six hypertensive patients and 34 obese patients were examined. LVH was determined echocardiographically and myocardial mass index was calculated according to Devereaux. Geometric type of remodeling was determined on the basis of left ventricular telediastolic dimension and relative myocardial wall thickness indices. Control group consisted of 52 healthy persons, 8 of whom had LVH. Mean value of myocardial mass index in hypertensive patients compared to obese patients were 166 +/- 33 vs. 160 +/- 28 g/m super(2), of respectively (p=0.5). Twenty hypertensive patients (30%) had concentric LVH, 31 patients (47%) had non-dilated eccentric LVH, 12 patients (18%) had dilated eccentric LVH and 3 had mixed type of LVH. 27 obese patients (79%) had non-dilated eccentric LVH, 5 patients (15%) had concentric LVH. A statistically significant difference between these two groups was determined (p=0.0154). Asymmetric septal hypertrophy (ASH) subtype within non-dilated eccentric LVH was analysed separately. A highly statistical significant difference was found in the occurrence of ASH in hypertensive patients (84%) compared to obese patients (37%) and control group (14%; p=0.00025). We conclude that in patients with the same level of LVH, hypertension induces concentric LVH and eccentric non-dilated LVH with ASH while in obese patients there is domination of eccentric non-dilated LVH without ASH.