Yalçin Fatih, Yalçin Hulya, Abraham Roselle, Abraham Theodore P
UCSF HEALTH, Department of Cardiology, University of California San Francisco, San Francisco, CA, USA.
Int J Cardiol Cardiovasc Risk Prev. 2021 Nov 2;11:200115. doi: 10.1016/j.ijcrp.2021.200115. eCollection 2021 Dec.
Heart responds to physiologic and pathologic conditions and sympathetic drive plays an important role. It has been documented that LV base is more dominantly affected by sympathetic drive compared to the other regions. LV base is more dominantly exposed to wall stress in the initial period of remodeling due to pressure-overload, since LV cavity is the largest at base. Basal septal hypertrophy (BSH) in cross-sectional data is associated with the early phase of hypertensive heart disease. BSH was confirmed by 3rd generation microscopic ultrasound in small animals. BSH as the closest location to increased afterload could be detected in variety of stress stimuli and result in a huge septal hypertrophy in advance cases possibly related to earlier exposure of hemodynamic stress to septal wall.
Effective geometric and functional evaluation of initial remodeling due to hemodynamic stress is important according to both human and animal data. These findings possibly contribute to early recognition of adaptive phase of hypertensive remodeling and more effective management in a timely fashion.
心脏对生理和病理状况会产生反应，交感神经驱动起重要作用。有文献记载，与其他区域相比，左心室基部受交感神经驱动的影响更为显著。在压力超负荷导致的重塑初期，由于左心室腔在基部最大，左心室基部更易受到壁应力的影响。横断面数据中的基底间隔肥厚（BSH）与高血压性心脏病的早期阶段相关。在小动物中，第三代显微超声证实了BSH的存在。作为最接近后负荷增加部位的BSH，在各种应激刺激中都能被检测到，在晚期病例中可能会导致巨大的间隔肥厚，这可能与血流动力学应力更早作用于间隔壁有关。
根据人类和动物数据，对血流动力学应力导致的初始重塑进行有效的几何和功能评估很重要。这些发现可能有助于早期识别高血压重塑的适应阶段，并及时进行更有效的管理。
