Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Department of Cardiology, University Hospital 'Dr Dragisa Misovic - Dedinje', Heroja Milana Tepica, Belgrade, Serbia.
J Hypertens. 2021 May 1;39(5):1040-1043. doi: 10.1097/HJH.0000000000002726.
Hypertensive heart disease (HHD) includes left ventricular (LV) functional and structural remodeling. For a long time, this involved only LV diastolic dysfunction and LV hypertrophy. However, development of imaging technique enabled more detailed insights into LV mechanics. Its impairment seems to be the first step in the cascade of HHD. Tissue characterization, obtained by cardiac magnetic resonance, opened a completely new chapter in the assessment of HHD. We report a case of a 47-year-old man who was referred to our department for a newly detected heart failure. CT angiography excluded relevant coronary disease and cardiac magnetic resonance revealed focuses of fibrosis in interventricular septum, in addition severely dilated LV with severely reduced ejection fraction. Considering the fact that the patient had longstanding uncontrolled arterial hypertension and that other causes of cardiac remodeling and dysfunction were excluded, we hypothesized that the multimodality imaging approach enabled prompt diagnosis of HHD.
高血压性心脏病（HHD）包括左心室（LV）功能和结构重塑。长期以来，这只涉及 LV 舒张功能障碍和 LV 肥厚。然而，成像技术的发展使我们能够更详细地了解 LV 力学。它的损伤似乎是 HHD 级联反应的第一步。心脏磁共振获得的组织特征为 HHD 的评估开辟了全新篇章。我们报告了一例 47 岁男性患者，因新发现的心力衰竭而被转诊至我科。CT 血管造影排除了相关的冠状动脉疾病，心脏磁共振显示室间隔有纤维灶，此外 LV 严重扩张，射血分数严重降低。考虑到患者患有长期未控制的动脉高血压，且排除了其他导致心脏重塑和功能障碍的原因，我们假设多模态成像方法能够快速诊断 HHD。
