ABSTRACT
Background: High blood pressure causes left ventricular hypertrophy, which is a negative prognostic factor among hypertensive patients. Aim: To assess left ventricular geometric remodeling patterns in patients with essential hypertension or with hypertension secondary to parenchymal renal disease. Material and Methods: We analyzed data from echocardiograms performed in 250patients with essential hypertension (150 females) and 100 patients with secondary hypertension (60 females). The interventricular septum and the left ventricular posterior wall thickness were measured in the parasternal long-axis. Left ventricular mass was calculated using the Devereaux formula. Results: The most common remodeling type in females and males with essential hypertension were eccentric and concentric left ventricular hypertrophy (cLVH), respectively. Among patients with secondary arterial hypertension, cLVH was most commonly observed in both genders. The prevalence of left ventricular hypertrophy was higher among patients with secondary hypertension. The left ventricular mass index and the relative left ventricular wall thickness were higher in males and also in the secondary hypertension group. Age, blood pressure values and the duration of hypertension, influenced remodeling patterns. Conclusions: We documented a higher prevalence of LVH among patients with secondary hypertension. The type of ventricular remodeling depends on gender, age, type of hypertension, blood pressure values and the duration of hypertension.
Antecedentes: La hipertensión arterial causa hipertrofia ventricular izquierda, un factor de mal pronóstico en pacientes hipertensos. Objetivo: Evaluar patrones de remodelación ventricular en pacientes con hipertensión arterial esencial y secundaria a daño renal. Material y Métodos: Análisis de ecocardiogramas efectuados a 250 pacientes con hipertensión arterial primaria (150 mujeres) y 100 pacientes con hipertensión secundaria (60 mujeres). Se midió el grosor del septum interventricular y de la pared ventricular posterior. La masa ventricular izquierda se calculó usando la fórmula de Devereaux. Resultados: Los tipos más frecuentes de remodelación ventricular en mujeres y hombres con hipertensión esencial fueron la hipertrofia ventricular excéntrica y concéntrica, respectivamente. En pacientes con hipertensión arterial secundaria, la hipertrofia concéntrica fue más frecuente. La prevalencia de hipertrofia ventricular izquierda fue más alta en pacientes con hipertensión secundaria. El índice de masa ventricular izquierda y el grosor relativo de la pared ventricular izquierda fueron mayores en pacientes con hipertensión secundaria. La edad, los valores de presión arterial y la duración de la hipertensión influyeron en los patrones de remodelación. Conclusiones: Documentamos una mayor prevalencia de hipertrofia ventricular izquierda en pacientes con hipertensión secundaria. El tipo de remodelación depende de la edad, género, tipo de hipertensión, valores de presión arterial y duración de la hipertensión.
Subject(s)
Female , Humans , Male , Middle Aged , Hypertension , Hypertrophy, Left Ventricular , Ventricular Remodeling , Age Factors , Blood Pressure/physiology , Echocardiography/methods , Hypertension/complications , Hypertension/physiopathology , Hypertrophy, Left Ventricular/etiology , Hypertrophy, Left Ventricular/physiopathology , Kidney Diseases/physiopathology , Kidney Diseases , Prevalence , Sex Factors , Time Factors , Ventricular Remodeling/physiology , Ventricular Septum/physiologyABSTRACT
BACKGROUND: High blood pressure causes left ventricular hypertrophy, which is a negative prognostic factor among hypertensive patients. AIM: To assess left ventricular geometric remodeling patterns in patients with essential hypertension or with hypertension secondary to parenchymal renal disease. MATERIAL AND METHODS: We analyzed data from echocardiograms performed in 250 patients with essential hypertension (150 females) and 100 patients with secondary hypertension (60 females). The interventricular septum and the left ventricular posterior wall thickness were measured in the parasternal long-axis. Left ventricular mass was calculated using the Devereaux formula. RESULTS: The most common remodeling type in females and males with essential hypertension were eccentric and concentric left ventricular hypertrophy (cLVH), respectively. Among patients with secondary arterial hypertension, cLVH was most commonly observed in both genders. The prevalence of left ventricular hypertrophy was higher among patients with secondary hypertension. The left ventricular mass index and the relative left ventricular wall thickness were higher in males and also in the secondary hypertension group. Age, blood pressure values and the duration of hypertension, influenced remodeling patterns. CONCLUSIONS: We documented a higher prevalence of LVH among patients with secondary hypertension. The type of ventricular remodeling depends on gender, age, type of hypertension, blood pressure values and the duration of hypertension.
Subject(s)
Hypertension/diagnostic imaging , Hypertrophy, Left Ventricular/diagnostic imaging , Ventricular Remodeling , Age Factors , Blood Pressure/physiology , Echocardiography/methods , Essential Hypertension , Female , Humans , Hypertension/complications , Hypertension/physiopathology , Hypertrophy, Left Ventricular/etiology , Hypertrophy, Left Ventricular/physiopathology , Kidney Diseases/diagnostic imaging , Kidney Diseases/physiopathology , Male , Middle Aged , Prevalence , Sex Factors , Time Factors , Ventricular Remodeling/physiology , Ventricular Septum/physiologyABSTRACT
There are frequent citations in the literature stating that lesions of the tendinous cords cause functional disorders of the heart valves. This led us to conduct the present investigation on the anatomy of the tendinous cords. Our objective was to focus on the morphological characteristics of tendinous cords that are inserted directly into the interventricular septum, such as their frequency, number, dimensions and This study was conducted on 50 hearts from adults of both sexes that had been fixed in 10% formaldehyde. The right ventricle was opened by means of an incision parallel to the anterior interventricular groove, and the left ventricle was opened by means of a longitudinal incision in the middle of the pulmonary (left) surface. Our results showed that, in the right ventricle, these tendinous cords constantly appeared without the involvement of papillary muscles (98%). They ranged in number from one to ten, and between two and five was the most common (72%). They were short, mostly ranging from 0.3 to 1.9 cm in length (81.5%) and were preferentially located in the upper third of the interventricular septum (71.4%). They were usually attached to the septal cusp (76.7%) and sometimes to the anterior cusp (21.3%). The cusp insertion sites were the free edge (62%), ventricular surface (32%) and basal edge (6%). It was exceptional to find tendinous cords in the ventricular septum of the left ventricle. Tendinous cords directly inserted into the atrioventricular septum were constantly present in the right ventricle, with varying numbers. They were predominantly short because they were inserted into the upper third of the septum and most often headed towards the septal cusp. It was exception to find tendinous cords in the atrioventricular septum of the left ventricle.