Chiariello M, Betocchi S
Cattedra di Cardiologia, II Facoltà di Medicina e Chirurgia, Università degli Studi Federico II, Napoli.
Cardiologia. 1991 Dec;36(12 Suppl 1):79-84.
Although left ventricular hypertrophy is an adaptative mechanism to increased load, its development represents a pathological state which can affect patients' health in many ways. Systemic hypertension is often associated to left ventricular hypertrophy; a correlation exists between ambulatory blood pressure monitoring daytime mean blood pressure values and left ventricular mass. Left ventricular hypertrophy is an independent risk factor for cardiovascular events, and the pattern of concentric left ventricular hypertrophy is associated with higher morbidity and mortality. The mechanism by which left ventricular hypertrophy impair life expectancy is not completely known; arrhythmias and ischemia may often develop in patients with secondary left ventricular hypertrophy and can contribute to worsen prognosis. Left ventricular mechanics is also affected by hypertrophy. Systolic function is usually normal at rest, but its response to exercise can be blunted when hypertrophy develops. Diastolic dysfunction is often present in patients with hypertension, even before left ventricular hypertrophy occurs, and it can impair systolic function by hampering filling resulting mostly in an impairment in the adjustment to exercise. Effective antihypertensive therapy leads to a decrease in left ventricular hypertrophy and an improvement in diastolic mechanics.
尽管左心室肥厚是对负荷增加的一种适应性机制，但其发展代表一种病理状态，可在许多方面影响患者健康。系统性高血压常与左心室肥厚相关；动态血压监测日间平均血压值与左心室质量之间存在相关性。左心室肥厚是心血管事件的独立危险因素，而向心性左心室肥厚模式与更高的发病率和死亡率相关。左心室肥厚损害预期寿命的机制尚不完全清楚；继发性左心室肥厚患者常发生心律失常和缺血，可导致预后恶化。左心室力学也受肥厚影响。静息时收缩功能通常正常，但当肥厚发展时，其对运动的反应可能减弱。舒张功能障碍在高血压患者中常存在，甚至在左心室肥厚发生之前就已出现，它可通过妨碍充盈损害收缩功能，主要导致运动适应性受损。有效的抗高血压治疗可导致左心室肥厚减轻和舒张力学改善。
