title: Left ventricular concentric remodelling and extracardiac target organ damage in essential hypertension.
abstract: Left ventricular (LV) concentric remodelling is an adaptive change in cardiac geometry frequently observed in arterial hypertension. This study was addressed to investigate the extent of extracardiac target organ damage (TOD) in patients with LV concentric remodelling. Two groups of never-treated essential hypertensives, 31 with normal LV geometry (group I, relative wall thickness: 0.39) and 31 with LV concentric remodelling (group II, relative wall thickness: 0.47) matched for age, sex, body mass index and mean 24-h systolic blood pressure (BP), were included in the study. They underwent clinical and laboratory examination, 24-h ambulatory BP monitoring (ABPM), 24-h urinary collection for microalbuminuria, non-mydriatic photography of ocular fundi, echocardiography and carotid ultrasonography. In both groups age (I: 51 +/- 11 years; II: 51 +/- 11 years), body mass index (I: 25 +/- 3 kg/m(2); II: 26 +/- 3 kg/m(2)), clinic and 24-h ABPM values (I: 149 +/- 11/95 +/- 8, 142 +/- 11/91 +/- 7 mm Hg; II: 150 +/- 11/98 +/- 9, 142 +/- 12/92 +/- 9 mm Hg) were similar by design. There were no differences between patients with normal LV geometry and with LV concentric remodelling in LVM index (97 +/- 16 vs 99 +/- 16), carotid intima-media thickness (0.7 +/- 0.02 vs 0.7 +/- 0.02) and carotid plaques prevalence (35% vs 35%). Furthermore, no significant differences among the two groups were found in the prevalence of retinal changes and microalbuminuria. These results suggest that in hypertensive patients with similar BP and LVMI levels, LV concentric remodelling is not associated with more prominent TOD.
authors.affiliation: Istituto di Clinica Medica e Terapia Medica and Centro di Fisiologia Clinica e Ipertensione, Università degli Studi di Milano, Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cuspidi
authors.forename: G
authors.initials: G
authors.lastname: Macca
authors.forename: I
authors.initials: I
authors.lastname: Michev
authors.forename: V
authors.initials: V
authors.lastname: Fusi
authors.forename: B
authors.initials: B
authors.lastname: Severgnini
authors.forename: C
authors.initials: C
authors.lastname: Corti
authors.forename: S
authors.initials: S
authors.lastname: Meani
authors.forename: C
authors.initials: C
authors.lastname: Valerio
authors.forename: C
authors.initials: C
authors.lastname: Sala
authors.forename: F
authors.initials: F
authors.lastname: Magrini
authors.forename: A
authors.initials: A
authors.lastname: Zanchetti
mesh_terms: D000419:Albuminuria / Q000652:urine; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D020257:Ventricular Remodeling