Frishman W H, Skolnick A E, Strom J A
Albert Einstein College of Medicine, Department of Medicine, Bronx, New York.
Circulation. 1989 Dec;80(6 Suppl):IV151-61.
Left ventricular hypertrophy (LVH) is a structural adaptation of the heart and is a response to increased hemodynamic and metabolic demands, which are most commonly caused by systemic hypertension. LVH induced by hypertension is associated with reduced myocardial compliance, structural alterations, and changes in coronary perfusion. Calcium entry blockers have caused LVH regression both in experimental studies and in clinical trials. Although their efficacy as antihypertensive agents is primarily due to their vasodilating properties, the mechanisms by which calcium entry blockers accomplish LVH regression are complex and include various hemodynamic and neurohumoral factors. Calcium entry blockade has decreased LVH with no apparent deterioration of left ventricular function. Because LVH is a major risk factor for sudden cardiac death and other cardiac morbidities, it is possible that the regression of LVH can improve the prognosis in hypertensive patients.
左心室肥厚(LVH)是心脏的一种结构适应性变化,是对血流动力学和代谢需求增加的一种反应,这种增加最常见的原因是系统性高血压。高血压所致的LVH与心肌顺应性降低、结构改变以及冠状动脉灌注变化有关。在实验研究和临床试验中,钙通道阻滞剂均可使LVH消退。虽然它们作为抗高血压药物的疗效主要归因于其血管舒张特性,但钙通道阻滞剂促使LVH消退的机制很复杂,包括多种血流动力学和神经体液因素。钙通道阻滞可使LVH减轻,而左心室功能无明显恶化。由于LVH是心源性猝死和其他心脏疾病的主要危险因素,因此LVH的消退有可能改善高血压患者的预后。