Aguilera Saldaña M A, García Moreno L M, Rodríguez Padial L, Navarro Lima A, Sánchez Domínguez J
Sección de Cardiología, Hospital Virgen de la Salud, Toledo.
Rev Esp Cardiol. 1990;43 Suppl 1:54-64.
Left ventricular hypertrophy, a known consequence of hypertension, is associated with an excess mortality independent of other known cardiovascular risk factors. There are multiple mechanisms in which left ventricular hypertrophy may account for this excess mortality including increased incidence of arrhythmias, systolic an diastolic dysfunction, relative ischemia, and associated coronary artery disease. Diastolic dysfunction, manifested by reduced ventricular distensibility of the hypertrophic left ventricle, appears to be an early characteristic of the hypertensive heart since echocardiographic techniques have demonstrated diastolic filling abnormalities in untreated essential hypertensives even before significant left ventricular hypertrophy appears. The presence of left ventricular hypertrophy is difficult to detect by electrocardiography. Echocardiography seems to be the best non-invasive method for the detection of hypertensive heart disease: it shows early abnormalities of left ventricular compliance, frequently left ventricular hypertrophy and late abnormalities of myocardial contractility.
左心室肥厚是高血压的一个已知后果，与独立于其他已知心血管危险因素的额外死亡率相关。左心室肥厚可能导致这种额外死亡率的机制有多种，包括心律失常发生率增加、收缩和舒张功能障碍、相对缺血以及相关的冠状动脉疾病。舒张功能障碍表现为肥厚的左心室舒张能力降低，似乎是高血压性心脏病的早期特征，因为超声心动图技术已证明，在未经治疗的原发性高血压患者中，甚至在出现明显的左心室肥厚之前，就存在舒张期充盈异常。通过心电图很难检测到左心室肥厚的存在。超声心动图似乎是检测高血压性心脏病的最佳非侵入性方法：它显示左心室顺应性的早期异常，常常显示左心室肥厚以及心肌收缩力的晚期异常。
