Messerli F H, Aepfelbacher F C
Department of Internal Medicine, Ochsner Clinic, New Orleans, Louisiana, USA.
Cardiol Clin. 1995 Nov;13(4):549-57.
Left-ventricular hypertrophy (LVH), the primary cardiac manifestation of hypertension, has been identified as the most powerful risk factor for future cardiovascular events causing morbidity and mortality, such as myocardial infarction, congestive heart failure, sudden death, and so forth. The increase in myocardial mass lowers coronary reserve and enhances cardiac oxygen requirements, gives rise to ventricular ectopy, and impairs left-ventricular filling and contractility. Besides hypertension, other risk factors such as obesity, advanced age, valvular heart disease, and other pathologic disorders can cause an increase in the hemodynamic burden and lead to LVH. Nonhemodynamic determinants of left-ventricular mass include dietary salt intake, alcohol, and neurohormones. LVH and its sequelae can be reduced by specific antihypertensive therapy, but despite these promising findings, future epidemiologic studies are necessary to document the clinical benefits of a reduction in LVH.
左心室肥厚（LVH）是高血压的主要心脏表现，已被确认为导致未来心血管事件（如心肌梗死、充血性心力衰竭、猝死等）发病和死亡的最强大危险因素。心肌质量增加会降低冠状动脉储备并增加心脏氧需求，引发室性异位心律，并损害左心室充盈和收缩功能。除了高血压外，其他危险因素如肥胖、高龄、瓣膜性心脏病和其他病理疾病也会增加血流动力学负担并导致左心室肥厚。左心室质量的非血流动力学决定因素包括饮食盐摄入量、酒精和神经激素。通过特定的抗高血压治疗可以减轻左心室肥厚及其后遗症，但尽管有这些令人鼓舞的发现，仍需要未来的流行病学研究来证明减轻左心室肥厚的临床益处。
