Przerost lewej komory serca – Etiologia i przyczyny

Przerost lewej komory serca
Etiologia i przyczyny

Przerost lewej komory serca (LVH) to adaptacyjny wzrost masy mięśnia lewej komory, wynikający z przeciążenia ciśnieniowego lub objętościowego, najczęściej spowodowany nadciśnieniem tętniczym oraz zwężeniem zastawki aortalnej. LVH może mieć charakter koncentryczny (przeciążenie ciśnieniowe) lub ekscentryczny (przeciążenie objętościowe), a jego patogeneza obejmuje m.in. aktywację układu renina-angiotensyna-aldosteron oraz czynniki genetyczne, zwłaszcza w kardiomiopatii przerostowej. Diagnostyka różnicowa LVH wymaga zaawansowanych metod obrazowych (CMR), biopsji endomiokardialnej oraz badań genetycznych, co jest istotne ze względu na różnice w leczeniu i rokowaniu. Warto podkreślić, że LVH jest silnym predyktorem chorobowości i śmiertelności sercowo-naczyniowej, a jego regresja pod wpływem terapii przeciwnadciśnieniowej znacząco poprawia przeżywalność pacjentów.

Wprowadzenie do przerostu lewej komory serca

Przerost lewej komory serca (ang. Left Ventricular Hypertrophy, LVH) to stan, w którym dochodzi do zwiększenia masy lewej komory serca w wyniku pogrubienia ściany komory, zwiększenia objętości jej jamy lub obu tych zjawisk jednocześnie¹. Pogrubienie ściany głównej pompy serca (lewej komory) może prowadzić do zwiększenia ciśnienia wewnątrz serca i utrudniać pompowanie krwi². Przerost lewej komory serca nie jest chorobą samą w sobie, ale często jest markerem choroby dotykającej serca, który pojawia się jako odpowiedź na zwiększone obciążenie tego narządu³.

Chociaż przerost komory może wystąpić naturalnie jako reakcja na ćwiczenia aerobowe i trening siłowy, najczęściej jest on wskaźnikiem patologicznej reakcji na chorobę układu sercowo-naczyniowego lub wysokie ciśnienie krwi⁴. Nieleczony przerost lewej komory serca (oraz powiązane podstawowe choroby serca) zwiększa ryzyko poważnych chorób serca, a nawet śmierci⁵.

Główne przyczyny przerostu lewej komory serca

Na przerost lewej komory serca może wpływać wiele czynników, które zwiększają napięcie lub objętość krwi w lewej komorze. Poniżej przedstawiono główne przyczyny tego stanu.

Nadciśnienie tętnicze

Nadciśnienie tętnicze (wysokie ciśnienie krwi) jest najczęstszą przyczyną przerostu lewej komory serca⁶⁷. Długotrwałe nadciśnienie tętnicze obciąża lewą stronę serca, powodując jej rozrost⁸. Kiedy ciśnienie krwi pozostaje wysokie, serce musi pracować znacznie ciężej, aby pompować krew. Lewa komora pogrubia się, aby skuteczniej pompować krew przy wyższym ciśnieniu⁹.

U osób z przewlekłym nadciśnieniem tętniczym ściana serca staje się grubsza z powodu stresu ściennego wywołanego nadciśnieniem¹⁰. Więcej niż jedna trzecia pacjentów wykazuje objawy przerostu lewej komory serca w momencie diagnozy nadciśnienia tętniczego¹¹.

Badania wykazały, że przerost lewej komory serca jest silnym predyktorem chorobowości sercowo-naczyniowej i śmiertelności ogólnej u pacjentów z nadciśnieniem tętniczym¹². Leczenie przeciwnadciśnieniowe, które powoduje regresję przerostu lewej komory serca, zmniejsza częstość występowania niekorzystnych zdarzeń sercowo-naczyniowych i poprawia przeżywalność, niezależnie od stopnia obniżenia ciśnienia krwi¹³.

Choroby zastawek serca

Choroby zastawek serca są kolejną główną przyczyną przerostu lewej komory serca. Szczególnie istotne są:

Zwężenie zastawki aortalnej (stenoza aortalna) – jest to drugi najczęstszy powód przerostu lewej komory serca po nadciśnieniu tętniczym¹⁴. Choroba ta polega na zwężeniu zastawki aortalnej, która oddziela lewą komorę od głównego naczynia krwionośnego wychodzącego z serca (aorty). Zwężenie zastawki wymaga od lewej komory cięższej pracy, aby pompować krew do aorty¹⁵.
Niedomykalność zastawki aortalnej – stan, w którym zastawka aortalna przecieka, powodując przepływ krwi w złym kierunku z powrotem do lewej komory¹⁶.
Niedomykalność zastawki mitralnej – występuje, gdy zastawka mitralna nie zamyka się szczelnie, powodując przepływ krwi w złym kierunku z powrotem do lewego przedsionka¹⁷. To prowadzi do przeciążenia objętościowego lewej komory.

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Kardiomiopatie

Różne formy kardiomiopatii mogą przyczyniać się do rozwoju przerostu lewej komory serca:

Kardiomiopatia przerostowa – jest to schorzenie genetyczne, w którym mięsień sercowy staje się nieprawidłowo gruby²¹. Kardiomiopatia przerostowa jest spowodowana mutacjami genów kodujących białka sarkomeru, co prowadzi do pogrubienia mięśnia sercowego²². To utrudnia pompowanie krwi przez serce i może wystąpić nawet przy normalnym ciśnieniu krwi²³. Osoby z jednym rodzicem chorym na kardiomiopatię przerostową mają 50% szans na posiadanie zmienionego genu, który powoduje tę chorobę²⁴.
Kardiomiopatia rozstrzeniowa – charakteryzuje się rozciągnięciem i powiększeniem komór (zwykle zaczynając od lewej i rozprzestrzeniając się na prawą). Możliwe przyczyny tego stanu to choroba wieńcowa, alkohol i infekcje²⁵.

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Choroby naciekowe i spichrzeniowe

Choroby naciekowe mogą prowadzić do przerostu lewej komory serca poprzez gromadzenie się nieprawidłowych białek lub innych substancji w mięśniu sercowym:

Amyloidoza – stan, w którym białka odkładają się wokół narządów, w tym serca²⁸. Gromadzenie się białek zakłóca funkcjonowanie narządów. Gdy stan ten jest dziedziczony w rodzinie, nazywany jest amyloidozą rodzinną i może również wpływać na nerwy i nerki²⁹.
Choroba Fabry’ego – jest to lizosomalna choroba spichrzeniowa dziedziczona w sposób recesywny sprzężony z chromosomem X, spowodowana niewystarczającą aktywnością enzymu alfa-galaktozydazy A³⁰. Dotknięci mężczyźni często przejawiają „klasyczną” postać choroby Fabry’ego charakteryzującą się postępującą dysfunkcją nerek, zmniejszoną potliwością, rogowaceniem słonecznym, parestezjami kończyn, udarem niedokrwiennym i ciężkim przerostem serca³¹.
Choroba Danona – kolejna rzadka choroba spichrzeniowa, która może powodować przerost lewej komory³².

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Inne czynniki przyczyniające się do przerostu lewej komory

Wrodzone wady serca

Niektóre wrodzone wady serca mogą przyczyniać się do rozwoju przerostu lewej komory:

Koarktacja aorty – wada wrodzona powodująca zwężenie części aorty, głównej tętnicy przenoszącej krew z serca do organizmu³⁵.
Zwężenie podzastawkowe aorty – zwężenie poniżej zastawki aortalnej w sercu³⁶.
Ubytek przegrody międzykomorowej – wada wrodzona obejmująca otwór w ścianie, która oddziela dolne komory serca³⁷.

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Intensywny trening sportowy

Intensywny, długotrwały trening wytrzymałościowy i siłowy może powodować zmiany w sercu nazywane „sercem sportowca”³⁹. Jest to adaptacja fizjologiczna serca do zwiększonego obciążenia pracą:

Intensywne i długotrwałe treningi wytrzymałościowe mogą powodować dostosowanie się serca do obsługi dodatkowego obciążenia pracą⁴⁰.
Nie jest jasne, czy ten sportowy typ przerostu lewej komory może prowadzić do usztywnienia mięśnia sercowego i choroby⁴¹.
U niektórych sportowców intensywny trening fizyczny może spowodować przerost ścian lewej komory⁴².
Ten rodzaj przerostu jest zwykle nieszkodliwy, a zdolność serca do kurczenia się i relaksacji pozostaje normalna⁴³.

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Cukrzyca i otyłość

Zarówno cukrzyca, jak i otyłość mogą przyczyniać się do rozwoju przerostu lewej komory serca:

Cukrzyca – podwyższony poziom cukru we krwi (hiperglikemia) przyczynia się do zwiększonej lepkości krwi, co może podwyższać ryzyko chorób sercowo-naczyniowych⁴⁶. Badania wykazały, że obecność cukrzycy wiąże się ze znacząco wyższym wskaźnikiem masy lewej komory w populacji z prawidłowym ciśnieniem w porównaniu do dopasowanych pod względem wieku i płci osób z grupy kontrolnej w zdrowej populacji⁴⁷.
Otyłość – podwyższone BMI jest „znacząco związane z przerostem lewej komory”⁴⁸. Bycie z nadwagą powoduje znaczne obciążenie serca, które musi pracować ciężej, prowadząc do pogrubienia mięśnia sercowego⁴⁹.

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Choroby nerek

Choroby nerek mogą przyczynić się do przerostu lewej komory:

Przewlekła choroba nerek – często prowadzi do nadciśnienia tętniczego, które może uszkodzić serce⁵².
Zwężenie tętnicy nerkowej – zwężenie tętnic doprowadzających krew do nerek⁵³.

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Mechanizmy patofizjologiczne przerostu lewej komory

Przerost lewej komory może rozwijać się różnymi mechanizmami patofizjologicznymi, w zależności od przyczyny podstawowej:

Przerosty koncentryczne i ekscentryczne

W zależności od typu obciążenia, przerost lewej komory można sklasyfikować jako:

Przerost koncentryczny – nieprawidłowy wzrost masy mięśnia lewej komory z powodu przeciążenia ciśnieniowego wynikającego z zwężenia tętniczek, które występuje w przewlekłym nadciśnieniu tętniczym lub zwężeniu zastawki aortalnej⁵⁶. Przy przewlekłym przeciążeniu ciśnieniowym, takim jak w przewlekłym nadciśnieniu tętniczym lub zwężeniu zastawki aortalnej, promień komory może nie ulec zmianie; jednakże grubość ściany zwiększa się, gdy nowe sarkomery są dodawane równolegle do istniejących sarkomerów⁵⁷.
Przerost ekscentryczny – wynika ze zwiększonego ciśnienia napełniania lewej komory lub przeciążenia rozkurczowego. Powstaje on w przypadkach wad zastawkowych z niedomykalnością, takich jak niedomykalność aortalna lub mitralna oraz w kardiomiopatii rozstrzeniowej⁵⁸. Przewlekłe rozszerzenie komory występuje w odpowiedzi na przewlekłe przeciążenie objętościowe stymulowane przez podwyższone ciśnienie końcoworozkurczowe w komorach. Rozszerzenie komory występuje, gdy nowe sarkomery są dodawane szeregowo do istniejących sarkomerów⁵⁹.

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Mechanizmy molekularne i komórkowe

Na poziomie molekularnym i komórkowym przerost lewej komory może być związany z:

Układem renina-angiotensyna-aldosteron – rozwój włóknienia mięśnia sercowego wydaje się być patofizjologicznie powiązany z układem renina-angiotensyna-aldosteron. Istnieją dowody, że angiotensyna II ma działanie profibrotyczne na mięsień sercowy u pacjentów z nadciśnieniem tętniczym⁶¹. Może to wyjaśniać, dlaczego inhibitory konwertazy angiotensyny (ACE) i blokery receptora angiotensyny II (ARB) są jednymi z najbardziej skutecznych leków w leczeniu przerostu lewej komory⁶².
Czynnikami genetycznymi – genomika może również odgrywać znaczącą rolę w patogenezie przerostu lewej komory. Zmutowane geny kodujące białka sarkomeru mają bezpośredni związek etiologiczny u pacjentów z kardiomiopatią przerostową⁶³. Dodatkowo, wydaje się, że istnieje genetyczna predyspozycja, która powoduje, że u niektórych pacjentów z łagodnym nadciśnieniem tętniczym rozwija się przerost lewej komory, podczas gdy u innych nie⁶⁴.
Nieprawidłowościami w organizacji komórek mięśnia sercowego – u osób z kardiomiopatią przerostową komórki mięśnia sercowego są ułożone inaczej. Nazywa się to dezorganizacją miofibrylli (myofiber disarray). Może to wywołać nieregularne bicie serca u niektórych osób⁶⁵.

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Rezerwa wieńcowonaczyniowa

Przerost lewej komory może wpływać na przepływ krwi w mięśniu sercowym:

Powody zmniejszonej rezerwy przepływu wieńcowego są złożone i obejmują strukturalne i funkcjonalne nieprawidłowości naczyń krwionośnych mięśnia sercowego, takie jak zmniejszona gęstość naczyń włosowatych, zmniejszona średnica światła małych tętnic śródmięśniowych oraz zwiększone napięcie naczyniowe⁶⁷.
Choroba wieńcowa wykazała związek z patogenezą przerostu lewej komory, gdy normalny mięsień sercowy próbuje kompensować tkankę, która stała się niedokrwiona lub zawałowa⁶⁸.

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Specjalne populacje i stany

Przerost lewej komory u niemowląt

Etiologia przerostu serca u niemowląt może różnić się od tej u dorosłych:

Najczęstszymi przyczynami przerostu serca u niemowląt są zespoły wad wrodzonych (w tym zespół Noonana) i cukrzyca matki⁷⁰.
W połowie zidentyfikowanych przyczyn (n=22) stwierdzono związek z hiperinsulinizmem, w tym cukrzyca matki (n=13), zespoły wad wrodzonych z insulinoopornością (n=6) i wrodzony hiperinsulinizm (n=3)⁷¹.
Inne znane przyczyny przerostu serca u niemowląt obejmują choroby metaboliczne (zaburzenia mitochondrialne i choroby spichrzeniowe, takie jak choroba Pompego), choroby sarkomeryczne (mutacje w genach białek kurczliwych sarkomeru sercowego MYH7, MYBPC3) i zaburzenia nerwowo-mięśniowe (takie jak ataksja Friedreicha)⁷².

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Przerost lewej komory związany z wiekiem i płcią

Wiek i płeć mogą wpływać na rozwój przerostu lewej komory:

Masa lewej komory zwiększa się wraz z wiekiem⁷⁴.
Kobiety są bardziej narażone niż mężczyźni na rozwój przerostu lewej komory⁷⁵.

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Diagnostyka różnicowa przerostu lewej komory

Diagnostyka różnicowa przerostu lewej komory może być trudna ze względu na podobieństwa w prezentacji klinicznej i cechach morfologicznych różnych manifestacji⁷⁷⁷⁸.

Diagnostyka różnicowa LVH wymaga serii kosztownych, inwazyjnych i czasochłonnych procedur, takich jak obrazowanie metodą rezonansu magnetycznego serca (CMR), biopsja endomiokardialna (EMB) i badania genetyczne⁷⁹. Rozróżnienie między tymi schorzeniami jest ważne ze względu na różnice w leczeniu i rokowaniu⁸⁰.

Chociaż podstawowa patofizjologia przerostu lewej komory różni się między nadciśnieniem tętniczym (zwiększone obciążenie następcze), kardiomiopatią przerostową (mutacja sarkomeru i dezorganizacja/dezorganizacja miofibrylli) i amyloidozą łańcuchów lekkich (infiltracja białka amyloidu), diagnostyka różnicowa jest często trudna na podstawie echokardiografii⁸¹. Trudności w diagnostyce różnicowej w echokardiografii prowadzą do późniejszego stosowania licznych nieinwazyjnych i inwazyjnych testów, takich jak CMR, EMB i badania genetyczne⁸².

Znaczenie rozpoznania przyczyny przerostu lewej komory

Prawidłowe zidentyfikowanie przyczyny przerostu lewej komory jest kluczowe dla odpowiedniego leczenia:

Jak wyjaśnia dr Jefferies, przerost lewej komory jest powszechnym problemem, ale jest również powszechnym objawem choroby Fabry’ego. Dlatego ważne jest, aby kardiolodzy określili przyczynę przerostu. W większości przypadków jest to niekontrolowane nadciśnienie tętnicze lub choroba nerek. Jednak jeśli przyczyną jest choroba Fabry’ego, leczenie może być ukierunkowane na terapię zastępczą enzymami w celu leczenia etiologii kardiomiopatii⁸³.

Najlepsze leczenie będzie zależeć od tego, co spowodowało LVH. Dla wielu osób nacisk będzie położony na leczenie wysokiego ciśnienia krwi. Kontrolowanie wysokiego ciśnienia krwi może zapobiec pogorszeniu się przerostu lewej komory. Może to pomóc zapobiec niewydolności serca. Może również pomóc obniżyć ryzyko zawału serca i udaru mózgu⁸⁴.

Jeśli przerost lewej komory był spowodowany problemem z sercem, możesz mieć inne opcje leczenia. Leczenie może pomóc obniżyć ryzyko niewydolności serca i innych poważnych problemów⁸⁵.

Leczenie przerostu lewej komory polega na zmianach stylu życia, lekach, operacji i wszczepialnych urządzeniach⁸⁶. Wybór terapii zawsze będzie zależeć od innych chorób współistniejących⁸⁷.

Podsumowanie przyczyn przerostu lewej komory serca

Przerost lewej komory serca może być spowodowany wieloma czynnikami, które zwiększają obciążenie pracą lewej komory serca. Najczęstszymi przyczynami są nadciśnienie tętnicze i zwężenie zastawki aortalnej. Inne przyczyny obejmują niedomykalność zastawek, kardiomiopatie, choroby naciekowe, wrodzone wady serca, intensywny trening sportowy, cukrzycę, otyłość i choroby nerek.

Zrozumienie podstawowej przyczyny przerostu lewej komory serca jest kluczowe dla odpowiedniego leczenia i prewencji poważnych powikłań sercowo-naczyniowych. Wczesna diagnoza i ukierunkowane leczenie podstawowego schorzenia mogą zapobiec progresji przerostu lewej komory serca i zmniejszyć ryzyko powikłań, takich jak niewydolność serca, zaburzenia rytmu serca i nagła śmierć sercowa.

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Materiały źródłowe

#1 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Left ventricular hypertrophy (LVH) is a condition in which an increase in left ventricular mass occurs secondary to an increase in wall thickness, an increase in left ventricular cavity enlargement, or both. […] There are various clinical conditions that can lead to the development of LVH. The most common of these include the following: Essential hypertension, Renal artery stenosis, Athletic heart with physiological LVH, Aortic valvar stenosis, Coarctation of the aorta, Hypertrophic cardiomyopathy without or with outflow tract obstruction (HOCM), Subaortic stenosis (left ventricular outflow tract obstruction by muscle or membrane), Aortic regurgitation, Mitral regurgitation, Dilated cardiomyopathy, Ventricular septal defect, Infiltrative cardiac processes (e.g., Amyloidosis, Fabry disease, Danon disease).
#2 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy is a thickening of the wall of the heart’s main pumping chamber, called the left ventricle. This thickening may increase pressure within the heart. The condition can make it harder for the heart to pump blood. The most common cause is high blood pressure. […] Uncontrolled high blood pressure is the most common cause of left ventricular hypertrophy. Complications include irregular heart rhythms, called arrhythmias, and heart failure. […] Anything that puts stress on the heart’s lower left chamber can cause left ventricular hypertrophy. The lower left chamber is called the left ventricle. As the strain on the lower left chamber increases, the muscle tissue in the chamber wall thickens. Sometimes, the size of the heart chamber itself also increases. […] High blood pressure. Also called hypertension, this is the most common cause of left ventricular hypertrophy. Long-term high blood pressure strains the left side of the heart, causing it to grow bigger. Treating high blood pressure can help reduce left ventricular hypertrophy symptoms and may even reverse it.
#3 Left ventricular hypertrophy – Wikipedia
https://en.wikipedia.org/wiki/Left_ventricular_hypertrophy
Left ventricular hypertrophy (LVH) is thickening of the heart muscle of the left ventricle of the heart, that is, left-sided ventricular hypertrophy and resulting increased left ventricular mass. […] While ventricular hypertrophy occurs naturally as a reaction to aerobic exercise and strength training, it is most frequently referred to as a pathological reaction to cardiovascular disease, or high blood pressure. […] While LVH itself is not a disease, it is usually a marker for disease involving the heart. […] Disease processes that can cause LVH include any disease that increases the afterload that the heart has to contract against, and some primary diseases of the muscle of the heart. […] Causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency and hypertension.
#4 Left ventricular hypertrophy – Wikipedia
https://en.wikipedia.org/wiki/Left_ventricular_hypertrophy
Left ventricular hypertrophy (LVH) is thickening of the heart muscle of the left ventricle of the heart, that is, left-sided ventricular hypertrophy and resulting increased left ventricular mass. […] While ventricular hypertrophy occurs naturally as a reaction to aerobic exercise and strength training, it is most frequently referred to as a pathological reaction to cardiovascular disease, or high blood pressure. […] While LVH itself is not a disease, it is usually a marker for disease involving the heart. […] Disease processes that can cause LVH include any disease that increases the afterload that the heart has to contract against, and some primary diseases of the muscle of the heart. […] Causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency and hypertension.
#5 Left Ventricular Hypertrophy (LVH)
https://my.clevelandclinic.org/health/diseases/21883-left-ventricular-hypertrophy
Left ventricular hypertrophy (LVH) is a thickening of muscles in the walls of your lower left heart chamber. This happens when your heart works too hard to pump against high pressure and a large volume of blood. […] The most common cause of left ventricular hypertrophy is high blood pressure (hypertension). High blood pressure makes your heart work harder than normal. The extra work it takes to pump blood can make the muscle in your left ventricle walls get larger and thicker. […] There are many different diseases and conditions that may cause LVH. […] Other conditions that can lead to LVH include: Heart valve disease. This may include a leak or narrowing in your aortic valve or a leak in your mitral valve. All of these make it harder for blood to get where it needs to go. […] Genetic diseases. More rarely, some inherited or acquired genetic variations can cause left ventricular hypertrophy, like Fabry disease and Danon disease, among others. […] Left untreated, LVH (and related underlying heart conditions) increases your risk of serious heart disease or even death. Treatment to slow or stop the progression of left ventricular hypertrophy lowers the risk of severe heart damage.
#6 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy is a thickening of the wall of the heart’s main pumping chamber, called the left ventricle. This thickening may increase pressure within the heart. The condition can make it harder for the heart to pump blood. The most common cause is high blood pressure. […] Uncontrolled high blood pressure is the most common cause of left ventricular hypertrophy. Complications include irregular heart rhythms, called arrhythmias, and heart failure. […] Anything that puts stress on the heart’s lower left chamber can cause left ventricular hypertrophy. The lower left chamber is called the left ventricle. As the strain on the lower left chamber increases, the muscle tissue in the chamber wall thickens. Sometimes, the size of the heart chamber itself also increases. […] High blood pressure. Also called hypertension, this is the most common cause of left ventricular hypertrophy. Long-term high blood pressure strains the left side of the heart, causing it to grow bigger. Treating high blood pressure can help reduce left ventricular hypertrophy symptoms and may even reverse it.
#7 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#8 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy is a thickening of the wall of the heart’s main pumping chamber, called the left ventricle. This thickening may increase pressure within the heart. The condition can make it harder for the heart to pump blood. The most common cause is high blood pressure. […] Uncontrolled high blood pressure is the most common cause of left ventricular hypertrophy. Complications include irregular heart rhythms, called arrhythmias, and heart failure. […] Anything that puts stress on the heart’s lower left chamber can cause left ventricular hypertrophy. The lower left chamber is called the left ventricle. As the strain on the lower left chamber increases, the muscle tissue in the chamber wall thickens. Sometimes, the size of the heart chamber itself also increases. […] High blood pressure. Also called hypertension, this is the most common cause of left ventricular hypertrophy. Long-term high blood pressure strains the left side of the heart, causing it to grow bigger. Treating high blood pressure can help reduce left ventricular hypertrophy symptoms and may even reverse it.
#9 Causes of Left Ventricular Hypertrophy Explained – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group
https://www.acibademhealthpoint.com/causes-of-left-ventricular-hypertrophy-explained/
Causes of Left Ventricular Hypertrophy Explained Left ventricular hypertrophy (LVH) makes the heartâs left ventricular muscle thicker. This happens when the heart works harder to pump blood. Knowing why LVH happens is key to catching it early and managing it. […] High blood pressure, genes, and lifestyle choices are top reasons for left ventricular hypertrophy. High blood pressure makes the heart work too hard, causing muscle thickening. Some people are more likely to get LVH because of their genes, even without other risks. Being overweight or training too hard can also raise the risk. […] High blood pressure is a big cause of LVH. When blood pressure stays high, the heart works too hard. The left ventricle gets thicker to pump blood against the high pressure. […] Genes also play a big part in LVH. If your family has heart issues, you might be more likely to get LVH. Some genes make the heart muscle thicker, making other problems worse.
#10 Understanding LVH Part 1: Concentric, Eccentric and Concentric Remodeling Cardioserv
https://www.cardioserv.net/understanding-lvh-part-1-concentric-eccentric-concentric-remodeling/
Left ventricular hypertrophy is a form of cardiac remodeling that causes the heart wall muscle to thicken, which leads to an increase in LV mass (LVM). […] There are key factors that play a major role in determining the presence of LVH: […] In patients with chronic high systolic blood pressure the heart wall will become thickened due to the wall stress from hypertension. […] Concentric LVH is the result of the heart adapting to high systemic pressure overload caused by hypertension or other diseases such as aortic stenosis. […] Eccentric hypertrophy deals with volume overload due to a significant valvular regurgitation issue or high cardiac index. […] Concentric remodeling is the late stage response to LV hypertrophy; caused by either chronic pressure, volume overload or a MI (which is commonly associated with CAD, but can be due to longstanding hypertension, especially untreated). […] Concentric LVH = Pressure Overload (BP) […] Eccentric LVH = Volume Overload (Regurgitation) […] Remodeling = CHRONIC pressure volume overload or MI.
#11 Left ventricular hypertrophy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
https://www.augustahealth.com/disease/left-ventricular-hypertrophy/
Left ventricular hypertrophy has several causes â one is an increase in the size of heart muscle cells and the other is abnormal tissue around the heart muscle cells. […] Your heart muscle cells may get larger in response to some factor that causes the left ventricle to work harder, such as high blood pressure or a heart condition. As the left ventricle’s workload increases, the muscle tissue in the chamber wall thickens. Sometimes, the size of the chamber itself also increases. […] Left ventricular hypertrophy may also develop due to problems in the structure of the heart muscle cell. These changes can be related to a genetic defect. Abnormal tissue around the heart muscle cells is a result of several rare conditions. […] Factors that can cause your heart to work harder include: High blood pressure (hypertension). This is the most common cause of left ventricular hypertrophy. More than one-third of people show evidence of left ventricular hypertrophy at the time of their diagnosis with hypertension.
#12 Left ventricular hypertrophy: An overlooked cardiovascular risk factor | MDedge
https://community.the-hospitalist.org/content/left-ventricular-hypertrophy-overlooked-cardiovascular-risk-factor
Left ventricular hypertrophy (LVH) strongly predicts cardiovascular morbidity and overall mortality in hypertensive patients. Antihypertensive treatment that causes LVH to regress decreases the rates of adverse cardiovascular events and improves survival, independent of how much the blood pressure is lowered. It is clinically important to recognize that LVH is a modifiable risk factor and that management is more complex than just blood pressure control. […] A CHRONICALLY ELEVATED CARDIAC WORKLOAD CAUSES LVH […] LVH is an abnormal increase in the mass of the left ventricular myocardium caused by a chronically increased workload on the heart. This most commonly results from the heart pumping against an elevated afterload, as in hypertension and aortic stenosis. Another notable cause is increased filling of the left ventricle (ie, diastolic overload), which is the underlying mechanism for LVH in patients with aortic or mitral regurgitation and dilated cardiomyopathy. Coronary artery disease can also play a role in the pathogenesis of LVH, as the normal myocardium attempts to compensate for the ischemic or infarcted tissue.
#13 Left ventricular hypertrophy: An overlooked cardiovascular risk factor | MDedge
https://community.the-hospitalist.org/content/left-ventricular-hypertrophy-overlooked-cardiovascular-risk-factor
Left ventricular hypertrophy (LVH) strongly predicts cardiovascular morbidity and overall mortality in hypertensive patients. Antihypertensive treatment that causes LVH to regress decreases the rates of adverse cardiovascular events and improves survival, independent of how much the blood pressure is lowered. It is clinically important to recognize that LVH is a modifiable risk factor and that management is more complex than just blood pressure control. […] A CHRONICALLY ELEVATED CARDIAC WORKLOAD CAUSES LVH […] LVH is an abnormal increase in the mass of the left ventricular myocardium caused by a chronically increased workload on the heart. This most commonly results from the heart pumping against an elevated afterload, as in hypertension and aortic stenosis. Another notable cause is increased filling of the left ventricle (ie, diastolic overload), which is the underlying mechanism for LVH in patients with aortic or mitral regurgitation and dilated cardiomyopathy. Coronary artery disease can also play a role in the pathogenesis of LVH, as the normal myocardium attempts to compensate for the ischemic or infarcted tissue.
#14 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#15 Left ventricular hypertrophy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
https://www.augustahealth.com/disease/left-ventricular-hypertrophy/
Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta. […] Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It’s unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease. […] Abnormalities in heart muscle cell structure that result in increased heart wall thickness include: Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood. […] Amyloidosis. A condition that causes abnormal protein deposits around the organs, including the heart.
#16 What Causes Left Ventricular Hypertrophy (LVH)?
https://www.verywellhealth.com/left-ventricular-hypertrophy-8728481
Aortic stenosis narrows the aortic valve, interfering with blood flowing from the left ventricle into the aorta. The increased pressure within the left ventricle causes the walls to thicken. […] Other causes of LVH include: Aortic regurgitation is when the aortic valve leaks, causing blood to reverse its flow (in the wrong direction) back into the left ventricle. […] Mitral regurgitation occurs when the mitral valve leaks, causing blood to reverse its flow (in the wrong direction) back into the left atrium (the upper chamber above the left ventricle). […] Dilated cardiomyopathy is characterized by stretching and enlargement of the ventricles (usually starting in the left and spreading to the right). Possible causes of this condition are coronary artery disease, alcohol, and infection.
#17 What Causes Left Ventricular Hypertrophy (LVH)?
https://www.verywellhealth.com/left-ventricular-hypertrophy-8728481
Aortic stenosis narrows the aortic valve, interfering with blood flowing from the left ventricle into the aorta. The increased pressure within the left ventricle causes the walls to thicken. […] Other causes of LVH include: Aortic regurgitation is when the aortic valve leaks, causing blood to reverse its flow (in the wrong direction) back into the left ventricle. […] Mitral regurgitation occurs when the mitral valve leaks, causing blood to reverse its flow (in the wrong direction) back into the left atrium (the upper chamber above the left ventricle). […] Dilated cardiomyopathy is characterized by stretching and enlargement of the ventricles (usually starting in the left and spreading to the right). Possible causes of this condition are coronary artery disease, alcohol, and infection.
#18 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Left ventricular hypertrophy (LVH) is a condition in which an increase in left ventricular mass occurs secondary to an increase in wall thickness, an increase in left ventricular cavity enlargement, or both. […] There are various clinical conditions that can lead to the development of LVH. The most common of these include the following: Essential hypertension, Renal artery stenosis, Athletic heart with physiological LVH, Aortic valvar stenosis, Coarctation of the aorta, Hypertrophic cardiomyopathy without or with outflow tract obstruction (HOCM), Subaortic stenosis (left ventricular outflow tract obstruction by muscle or membrane), Aortic regurgitation, Mitral regurgitation, Dilated cardiomyopathy, Ventricular septal defect, Infiltrative cardiac processes (e.g., Amyloidosis, Fabry disease, Danon disease).
#19 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#20 Left Ventricular Hypertrophy (LVH)
https://my.clevelandclinic.org/health/diseases/21883-left-ventricular-hypertrophy
Left ventricular hypertrophy (LVH) is a thickening of muscles in the walls of your lower left heart chamber. This happens when your heart works too hard to pump against high pressure and a large volume of blood. […] The most common cause of left ventricular hypertrophy is high blood pressure (hypertension). High blood pressure makes your heart work harder than normal. The extra work it takes to pump blood can make the muscle in your left ventricle walls get larger and thicker. […] There are many different diseases and conditions that may cause LVH. […] Other conditions that can lead to LVH include: Heart valve disease. This may include a leak or narrowing in your aortic valve or a leak in your mitral valve. All of these make it harder for blood to get where it needs to go. […] Genetic diseases. More rarely, some inherited or acquired genetic variations can cause left ventricular hypertrophy, like Fabry disease and Danon disease, among others. […] Left untreated, LVH (and related underlying heart conditions) increases your risk of serious heart disease or even death. Treatment to slow or stop the progression of left ventricular hypertrophy lowers the risk of severe heart damage.
#21 Left ventricular hypertrophy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
https://www.augustahealth.com/disease/left-ventricular-hypertrophy/
Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta. […] Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It’s unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease. […] Abnormalities in heart muscle cell structure that result in increased heart wall thickness include: Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood. […] Amyloidosis. A condition that causes abnormal protein deposits around the organs, including the heart.
#22 Hypertrophic Cardiomyopathy: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/152913-overview
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease. This disorder is caused by a mutations in genes encoding cardiac sarcomere protein, resulting in variety of phenotypical expression and clinical course. HCM is the most common cause of sudden death in young people. […] Familial HCM occurs as an autosomal dominant Mendelian-inherited disease in approximately 50% of cases. Some, if not all, of the sporadic forms of the disease may be caused by spontaneous mutations. […] At least 6 different genes on at least 4 chromosomes are associated with HCM, with more than 50 different mutations discovered thus far. Familial HCM is a genetically heterogenous disease in that it can be caused by genetic defects at more than 1 locus. […] Other possible causes of HCM include the following: Abnormal sympathetic stimulation – Heightened responsiveness of the heart to the excessive production of catecholamines or the reduced neuronal uptake of norepinephrine might cause HCM
#23 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy also may be caused by gene changes that affect the heart muscle’s structure. […] Certain conditions passed down through families, called genetic conditions, can make the heart thicker. They include: Hypertrophic cardiomyopathy. This condition is caused by changes in genes that cause the heart muscle to thicken. The thickening makes it harder for the heart to pump blood. It can occur even without high blood pressure. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the changed gene that causes the disease. […] Amyloidosis. Proteins build up around the organs, including the heart. The collection of proteins interferes with how the organs work. When the condition is passed down through families, it is called familial amyloidosis. It also may affect the nerves and kidneys.
#24 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy also may be caused by gene changes that affect the heart muscle’s structure. […] Certain conditions passed down through families, called genetic conditions, can make the heart thicker. They include: Hypertrophic cardiomyopathy. This condition is caused by changes in genes that cause the heart muscle to thicken. The thickening makes it harder for the heart to pump blood. It can occur even without high blood pressure. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the changed gene that causes the disease. […] Amyloidosis. Proteins build up around the organs, including the heart. The collection of proteins interferes with how the organs work. When the condition is passed down through families, it is called familial amyloidosis. It also may affect the nerves and kidneys.
#25 What Causes Left Ventricular Hypertrophy (LVH)?
https://www.verywellhealth.com/left-ventricular-hypertrophy-8728481
Aortic stenosis narrows the aortic valve, interfering with blood flowing from the left ventricle into the aorta. The increased pressure within the left ventricle causes the walls to thicken. […] Other causes of LVH include: Aortic regurgitation is when the aortic valve leaks, causing blood to reverse its flow (in the wrong direction) back into the left ventricle. […] Mitral regurgitation occurs when the mitral valve leaks, causing blood to reverse its flow (in the wrong direction) back into the left atrium (the upper chamber above the left ventricle). […] Dilated cardiomyopathy is characterized by stretching and enlargement of the ventricles (usually starting in the left and spreading to the right). Possible causes of this condition are coronary artery disease, alcohol, and infection.
#26 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Left ventricular hypertrophy (LVH) is a condition in which an increase in left ventricular mass occurs secondary to an increase in wall thickness, an increase in left ventricular cavity enlargement, or both. […] There are various clinical conditions that can lead to the development of LVH. The most common of these include the following: Essential hypertension, Renal artery stenosis, Athletic heart with physiological LVH, Aortic valvar stenosis, Coarctation of the aorta, Hypertrophic cardiomyopathy without or with outflow tract obstruction (HOCM), Subaortic stenosis (left ventricular outflow tract obstruction by muscle or membrane), Aortic regurgitation, Mitral regurgitation, Dilated cardiomyopathy, Ventricular septal defect, Infiltrative cardiac processes (e.g., Amyloidosis, Fabry disease, Danon disease).
#27 Left ventricular hypertrophy – Wikipedia
https://en.wikipedia.org/wiki/Left_ventricular_hypertrophy
Primary disease of the muscle of the heart that cause LVH are known as hypertrophic cardiomyopathies, which can lead into heart failure. […] Long-standing mitral insufficiency also leads to LVH as a compensatory mechanism. […] LV mass increases with ageing. […] Associated genes include OGN, osteoglycin.
#28 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy also may be caused by gene changes that affect the heart muscle’s structure. […] Certain conditions passed down through families, called genetic conditions, can make the heart thicker. They include: Hypertrophic cardiomyopathy. This condition is caused by changes in genes that cause the heart muscle to thicken. The thickening makes it harder for the heart to pump blood. It can occur even without high blood pressure. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the changed gene that causes the disease. […] Amyloidosis. Proteins build up around the organs, including the heart. The collection of proteins interferes with how the organs work. When the condition is passed down through families, it is called familial amyloidosis. It also may affect the nerves and kidneys.
#29 Left ventricular hypertrophy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/left-ventricular-hypertrophy/symptoms-causes/syc-20374314
Left ventricular hypertrophy also may be caused by gene changes that affect the heart muscle’s structure. […] Certain conditions passed down through families, called genetic conditions, can make the heart thicker. They include: Hypertrophic cardiomyopathy. This condition is caused by changes in genes that cause the heart muscle to thicken. The thickening makes it harder for the heart to pump blood. It can occur even without high blood pressure. People with one parent with hypertrophic cardiomyopathy have a 50% chance of having the changed gene that causes the disease. […] Amyloidosis. Proteins build up around the organs, including the heart. The collection of proteins interferes with how the organs work. When the condition is passed down through families, it is called familial amyloidosis. It also may affect the nerves and kidneys.
#30 Evaluation of the Patient with Incidental Left Ventricular Hypertrophy on Echocardiography â ScienceOpen
https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2019.0011
Fabry disease (FD) is an X-linked recessive lysosomal storage disorder due to insufficient activity of the GLA-encoded enzyme Î±-galactosidase A. […] Affected males frequently manifest âclassicâ FD characterized by progressive renal dysfunction, hypohidrosis, actinic keratosis (trunk, groin), acral paresthesias of the extremities, ischemic stroke, and severe cardiac hypertrophy. […] Cardiac manifestations on TTE may be indistinguishable from HCM, including asymmetric septal hypertrophy, dynamic left ventricular obstruction, and occasionally apical pouch. […] LVH is a common, albeit nonspecific, manifestation of multiple cardiac disorders.
#31 Evaluation of the Patient with Incidental Left Ventricular Hypertrophy on Echocardiography â ScienceOpen
https://www.scienceopen.com/hosted-document?doi=10.15212/CVIA.2019.0011
Fabry disease (FD) is an X-linked recessive lysosomal storage disorder due to insufficient activity of the GLA-encoded enzyme Î±-galactosidase A. […] Affected males frequently manifest âclassicâ FD characterized by progressive renal dysfunction, hypohidrosis, actinic keratosis (trunk, groin), acral paresthesias of the extremities, ischemic stroke, and severe cardiac hypertrophy. […] Cardiac manifestations on TTE may be indistinguishable from HCM, including asymmetric septal hypertrophy, dynamic left ventricular obstruction, and occasionally apical pouch. […] LVH is a common, albeit nonspecific, manifestation of multiple cardiac disorders.
#32 Left Ventricular Hypertrophy (LVH)
https://my.clevelandclinic.org/health/diseases/21883-left-ventricular-hypertrophy
Left ventricular hypertrophy (LVH) is a thickening of muscles in the walls of your lower left heart chamber. This happens when your heart works too hard to pump against high pressure and a large volume of blood. […] The most common cause of left ventricular hypertrophy is high blood pressure (hypertension). High blood pressure makes your heart work harder than normal. The extra work it takes to pump blood can make the muscle in your left ventricle walls get larger and thicker. […] There are many different diseases and conditions that may cause LVH. […] Other conditions that can lead to LVH include: Heart valve disease. This may include a leak or narrowing in your aortic valve or a leak in your mitral valve. All of these make it harder for blood to get where it needs to go. […] Genetic diseases. More rarely, some inherited or acquired genetic variations can cause left ventricular hypertrophy, like Fabry disease and Danon disease, among others. […] Left untreated, LVH (and related underlying heart conditions) increases your risk of serious heart disease or even death. Treatment to slow or stop the progression of left ventricular hypertrophy lowers the risk of severe heart damage.
#33 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Left ventricular hypertrophy (LVH) is a condition in which an increase in left ventricular mass occurs secondary to an increase in wall thickness, an increase in left ventricular cavity enlargement, or both. […] There are various clinical conditions that can lead to the development of LVH. The most common of these include the following: Essential hypertension, Renal artery stenosis, Athletic heart with physiological LVH, Aortic valvar stenosis, Coarctation of the aorta, Hypertrophic cardiomyopathy without or with outflow tract obstruction (HOCM), Subaortic stenosis (left ventricular outflow tract obstruction by muscle or membrane), Aortic regurgitation, Mitral regurgitation, Dilated cardiomyopathy, Ventricular septal defect, Infiltrative cardiac processes (e.g., Amyloidosis, Fabry disease, Danon disease).
#34 Left Ventricular Hypertrophy: Etiology-Based Therapeutic Options – PubMed
https://pubmed.ncbi.nlm.nih.gov/35353354/
Determining the etiologies of left ventricular hypertrophy (LVH) can be challenging due to the similarities of the different manifestations in clinical presentation and morphological features. […] Frequent causes of hypertrophy include etiologies due to pressure/volume overload, such as systemic hypertension, hypertrophic cardiomyopathy, or infiltrative cardiac processes such as amyloidosis, Fabry disease, and sarcoidosis. […] Hypertension and aortic valve stenosis are the most common causes of LVH.
#35 Left Ventricular Hypertrophy – MD Searchlight
https://mdsearchlight.com/heart-health/left-ventricular-hypertrophy/
Left ventricular hypertrophy (LVH) is a medical condition where the left ventricle of your heart, which is one of its four chambers, becomes larger than usual. This enlargement can either be because the wall of the ventricle becomes thicker or because the part of the heart that holds blood gets bigger, or both. Most often, the wall of the left ventricle thickens as a reaction to extra pressure, and the chamber becomes enlarged if there’s too much volume or amount of blood. […] Several health conditions can cause the thickening of the left side of your heart, a condition known as LVH or Left Ventricular Hypertrophy. The most commonly seen causes include: 1. Essential hypertension: High blood pressure that doesn’t have an identifiable cause. 2. Renal artery stenosis: The narrowing of the arteries that carry blood to your kidneys. 3. Athletic heart with physiological LVH: An enlarged heart due to high levels of physical activity. 4. Aortic valvar stenosis: The narrowing of the heart’s aortic valve. 5. Coarctation of the aorta: A birth defect that causes narrowing in part of the aorta, the major artery carrying blood from the heart to the body. 6. Hypertrophic cardiomyopathy: A disease in which the heart muscle becomes abnormally thick. 7. Subaortic stenosis: A narrowing below the aortic valve in the heart. 8. Aortic regurgitation: Leakage of the heart’s aortic valve causes blood to flow in the wrong direction. 9. Mitral regurgitation: A condition in which the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward in the heart. 10. Dilated cardiomyopathy: A condition where the heart’s ability to pump blood is lessened because the heart’s main pumping chamber, the left ventricle, is enlarged and weakened. 11. Ventricular septal defect: A birth defect that involves a hole in the wall that separates the heart’s lower chambers. 12. Infiltrative cardiac processes like Amyloidosis, Fabry disease, Danon disease: These are conditions where harmful substances build up in the heart.
#36 Left Ventricular Hypertrophy – MD Searchlight
https://mdsearchlight.com/heart-health/left-ventricular-hypertrophy/
Left ventricular hypertrophy (LVH) is a medical condition where the left ventricle of your heart, which is one of its four chambers, becomes larger than usual. This enlargement can either be because the wall of the ventricle becomes thicker or because the part of the heart that holds blood gets bigger, or both. Most often, the wall of the left ventricle thickens as a reaction to extra pressure, and the chamber becomes enlarged if there’s too much volume or amount of blood. […] Several health conditions can cause the thickening of the left side of your heart, a condition known as LVH or Left Ventricular Hypertrophy. The most commonly seen causes include: 1. Essential hypertension: High blood pressure that doesn’t have an identifiable cause. 2. Renal artery stenosis: The narrowing of the arteries that carry blood to your kidneys. 3. Athletic heart with physiological LVH: An enlarged heart due to high levels of physical activity. 4. Aortic valvar stenosis: The narrowing of the heart’s aortic valve. 5. Coarctation of the aorta: A birth defect that causes narrowing in part of the aorta, the major artery carrying blood from the heart to the body. 6. Hypertrophic cardiomyopathy: A disease in which the heart muscle becomes abnormally thick. 7. Subaortic stenosis: A narrowing below the aortic valve in the heart. 8. Aortic regurgitation: Leakage of the heart’s aortic valve causes blood to flow in the wrong direction. 9. Mitral regurgitation: A condition in which the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward in the heart. 10. Dilated cardiomyopathy: A condition where the heart’s ability to pump blood is lessened because the heart’s main pumping chamber, the left ventricle, is enlarged and weakened. 11. Ventricular septal defect: A birth defect that involves a hole in the wall that separates the heart’s lower chambers. 12. Infiltrative cardiac processes like Amyloidosis, Fabry disease, Danon disease: These are conditions where harmful substances build up in the heart.
#37 Left Ventricular Hypertrophy – MD Searchlight
https://mdsearchlight.com/heart-health/left-ventricular-hypertrophy/
Left ventricular hypertrophy (LVH) is a medical condition where the left ventricle of your heart, which is one of its four chambers, becomes larger than usual. This enlargement can either be because the wall of the ventricle becomes thicker or because the part of the heart that holds blood gets bigger, or both. Most often, the wall of the left ventricle thickens as a reaction to extra pressure, and the chamber becomes enlarged if there’s too much volume or amount of blood. […] Several health conditions can cause the thickening of the left side of your heart, a condition known as LVH or Left Ventricular Hypertrophy. The most commonly seen causes include: 1. Essential hypertension: High blood pressure that doesn’t have an identifiable cause. 2. Renal artery stenosis: The narrowing of the arteries that carry blood to your kidneys. 3. Athletic heart with physiological LVH: An enlarged heart due to high levels of physical activity. 4. Aortic valvar stenosis: The narrowing of the heart’s aortic valve. 5. Coarctation of the aorta: A birth defect that causes narrowing in part of the aorta, the major artery carrying blood from the heart to the body. 6. Hypertrophic cardiomyopathy: A disease in which the heart muscle becomes abnormally thick. 7. Subaortic stenosis: A narrowing below the aortic valve in the heart. 8. Aortic regurgitation: Leakage of the heart’s aortic valve causes blood to flow in the wrong direction. 9. Mitral regurgitation: A condition in which the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward in the heart. 10. Dilated cardiomyopathy: A condition where the heart’s ability to pump blood is lessened because the heart’s main pumping chamber, the left ventricle, is enlarged and weakened. 11. Ventricular septal defect: A birth defect that involves a hole in the wall that separates the heart’s lower chambers. 12. Infiltrative cardiac processes like Amyloidosis, Fabry disease, Danon disease: These are conditions where harmful substances build up in the heart.
#38 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Left ventricular hypertrophy (LVH) is a condition in which an increase in left ventricular mass occurs secondary to an increase in wall thickness, an increase in left ventricular cavity enlargement, or both. […] There are various clinical conditions that can lead to the development of LVH. The most common of these include the following: Essential hypertension, Renal artery stenosis, Athletic heart with physiological LVH, Aortic valvar stenosis, Coarctation of the aorta, Hypertrophic cardiomyopathy without or with outflow tract obstruction (HOCM), Subaortic stenosis (left ventricular outflow tract obstruction by muscle or membrane), Aortic regurgitation, Mitral regurgitation, Dilated cardiomyopathy, Ventricular septal defect, Infiltrative cardiac processes (e.g., Amyloidosis, Fabry disease, Danon disease).
#39 Left ventricular hypertrophy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
https://www.augustahealth.com/disease/left-ventricular-hypertrophy/
Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta. […] Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It’s unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease. […] Abnormalities in heart muscle cell structure that result in increased heart wall thickness include: Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood. […] Amyloidosis. A condition that causes abnormal protein deposits around the organs, including the heart.
#40 Left ventricular hypertrophy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
https://www.augustahealth.com/disease/left-ventricular-hypertrophy/
Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta. […] Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It’s unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease. […] Abnormalities in heart muscle cell structure that result in increased heart wall thickness include: Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood. […] Amyloidosis. A condition that causes abnormal protein deposits around the organs, including the heart.
#41 Left ventricular hypertrophy – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube
https://www.augustahealth.com/disease/left-ventricular-hypertrophy/
Aortic valve stenosis. This disease is a narrowing of the aortic valve that separates the left ventricle from the large blood vessel leaving your heart (aorta). The narrowing of the aortic valve requires the left ventricle to work harder to pump blood into the aorta. […] Athletic training. Intense, prolonged endurance and strength training can cause the heart to adapt to handle the extra workload. It’s unclear whether this athletic type of left ventricle hypertrophy can lead to stiffening of the heart muscle and disease. […] Abnormalities in heart muscle cell structure that result in increased heart wall thickness include: Hypertrophic cardiomyopathy. This genetic disease occurs when the heart muscle becomes abnormally thick, even with completely normal blood pressure, making it harder for the heart to pump blood. […] Amyloidosis. A condition that causes abnormal protein deposits around the organs, including the heart.
#42 Left Ventricular Hypertrophy Symptoms/Causes – Orange County
https://www.hoag.org/specialties-services/heart-vascular/specialty-programs/heart-failure-program/conditions/left-ventricular-hypertrophy/
The aortic valve can sometimes become narrowed, a condition called aortic stenosis. This condition can require the heart muscle to work harder to force blood through this narrowed opening, which can thicken the left ventricle walls. […] Congenital heart defects are issues with the structure of the heart or heart valves that are present at birth. […] In rare cases, intense athletic training can increase the thickness of the left ventricle walls. […] There are a number of other medical conditions that can make the heart work harder and result in LVH. […] If left untreated, left ventricular hypertrophy can increase the risk of serious complications and symptoms, including serious heart disease or even death. […] Women are more likely than men to develop left ventricular hypertrophy.
#43 Left Ventricular Hypertrophy – MD Searchlight
https://mdsearchlight.com/heart-health/left-ventricular-hypertrophy/
The top two causes, hypertension and aortic valve stenosis, make your heart work harder against high blood pressure. Another cause is the heart getting too full, as seen in conditions like aortic or mitral regurgitation and dilated cardiomyopathy. Sometimes, LVH can be a result of the heart’s healthy tissue working harder to compensate for diseased tissue, as seen in coronary artery disease. […] Physical exercise can also cause LVH, where intense training leads to an increase in heart muscle size, thickness, and the size of the chambers. This condition is generally harmless, and the heart’s ability to contract and relax remains normal.
#44 Understanding Left Ventricular Hypertrophy (LVH) | Saint Luke’s Health System
https://www.saintlukeskc.org/health-library/understanding-left-ventricular-hypertrophy-lvh
Left ventricular hypertrophy (LVH) is a condition where the size of the heart muscle is larger than normal. LVH can happen over time if you have certain health conditions that overwork the heart muscle, such as high blood pressure or aortic stenosis. […] LVH is often caused by other health problems, such as: High blood pressure (this is the main cause), Heart valve problems, such as aortic valve stenosis, aortic valve regurgitation, or mitral valve regurgitation, A genetic condition in which the heart muscle grow abnormally thick and stiff (hypertrophic cardiomyopathy), Some congenital heart conditions, such as coarctation of the aorta. […] In addition, LVH is sometimes seen in high-level athletes (called physiologic LVH). Over time, intense endurance and strength training can cause the heart to adapt to handle the extra workload.
#45 Left ventricular hypertrophy | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/left-ventricular-hypertrophy?lang=us
Left ventricular hypertrophy (LVH) is present when the left ventricular mass is increased. It is a common condition, typically due to systemic hypertension, and it increases with age, obesity and severity of hypertension. […] Left ventricular hypertrophy may result from either increased pressure or volume afterload on the heart. Much more rarely it may result from genetic conditions. The relationship between obesity and left ventricular hypertrophy is complex. […] A large number of conditions can cause left ventricular hypertrophy. […] hypertension: pressure overload […] valvular heart disease […] obesity […] genetic diseases […] severe physical exercise.
#46 Left Ventricular Hypertrophy | CardioVascular Health Clinicsearchenvelope-oexclamation-circlechevron-downlinkedin-squarephonefacebookuser-mdinstagramcrossmenu
https://cvhealthclinic.com/conditions-treated/left-ventricular-hypertrophy/
Left ventricular hypertrophy is a common contributor to potentially serious heart complications, affecting an estimated 15% of the United States population. […] Left ventricular hypertrophy commonly develops as a consequence of other cardiovascular conditions. Combined, they can heighten your risk of life-threatening health issues. […] Generally, left ventricular hypertrophy occurs due to high blood pressure, known clinically as hypertension. Your heart works harder when you have high blood pressure, and the additional strain leads to the thickening of the left ventricle walls. […] Though high blood pressure is the most common contributing factor, in some instances, aggressive exercise and intense physical training can cause the left ventricle walls to become thicker. […] Additional factors that contribute to elevated heart strain that can cause left ventricular hypertrophy include the following: Heart arrhythmia: The heart may beat faster than usual when it has an irregular rhythm. An elevated heart rate can cause damage to the heart, resulting in impeded blood flow. […] Aortic valve stenosis: A narrowing of the aortic valve makes blood circulation less efficient. […] Diabetes: Elevated blood sugar levels (hyperglycemia) contribute to increased blood viscosity, which can elevate the risk of cardiovascular disease.
#47
https://www.gehealthcare.com/insights/article/causes-of-left-ventricular-hypertrophy-when-two-enemies-join-forces?srsltid=AfmBOopcO9PVbbPvXvE4R6doXF9ayPFO70BvfJSS2hu_iOLOtuPeNsjU
Left ventricular hypertrophy develops when the myocardial cells experience growth, or hypertrophy, resulting in structural changes in the heart. […] This is the case for diabetes and hypertension, which can work in tandem to worsen left ventricular hypertrophy (LVH). […] When both of these conditions occur in the same patient, the risk of LVH increases considerably. […] It can develop as a result of either diabetes or hypertension; when both are present, the adverse manifestations can be compounded. […] Research has identified that the hormone fibroblast growth factor (FGF) 21 is elevated and dysfunctional in diabetics, resulting in direct hypertrophy of myocardial cells and LVH in mice. […] From a clinical perspective, the presence of diabetes was found to be associated with a significantly higher left ventricular mass index in a normotensive population compared to age-matched and sex-matched controls in a healthy population.
#48
https://www.gehealthcare.com/insights/article/causes-of-left-ventricular-hypertrophy-when-two-enemies-join-forces?srsltid=AfmBOopcO9PVbbPvXvE4R6doXF9ayPFO70BvfJSS2hu_iOLOtuPeNsjU
Obesity can also play a role in the development of LVH. Elevated BMI is „significantly associated with LVH,” and the duration and the degree of glycemic control (as reflected by the HbA1c) was also significantly associated with the degree of LVH. […] Diabetes and hypertension, with their rapidly rising prevalence and incidence, are two of the most formidable contributors to heart disease morbidity and mortality. Both can manifest with LVH and diastolic dysfunction.
#49 Causes of Left Ventricular Hypertrophy Explained – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group
https://www.acibademhealthpoint.com/causes-of-left-ventricular-hypertrophy-explained/
High blood pressure makes the heart work too hard. This can make the heart’s left ventricle muscle thicken. This is called hypertrophy. […] Yes, genes can affect LVH. If your family has heart issues, you might be more likely to get LVH. […] Acibadem Healthcare Group has studied LVH a lot. They found many risk factors and the need for early detection. They say we should check our heart health often and get the right treatment for LVH. […] Being overweight puts a lot of strain on the heart. This makes the heart work too hard. It can make the heart muscle thicken, leading to LVH. […] Training hard can make the heart muscle thicken. This is good for athletes, but too much can be bad. Acibadem Healthcare Group says athletes should check their heart health often. […] Aortic stenosis makes it hard for blood to flow out of the heart. This makes the left ventricle thicken. Mitral valve regurgitation also makes the left ventricle work too hard, leading to hypertrophy.
#50 Left Ventricular Hypertrophy: Risk Factors, Symptoms, and Treatment
https://www.healthline.com/health/left-ventricular-hypertrophy
Left ventricular hypertrophy (LVH) is when the hearts main pumping chamber, the left ventricle, becomes thicker and less able to pump blood efficiently. It usually develops because of another heart condition and treating that condition may stop progression or reverse LVH. […] A 2022 study suggests that the primary causes of LVH are high blood pressure and aortic valve stenosis, a condition in which the valve leading from the left ventricle to the aorta becomes stiff and can no longer open sufficiently to let the proper amount of blood enter the blood vessel. […] Because high blood pressure (hypertension) means the heart is working harder to pump blood throughout the body, the left ventricles walls can grow thicker and larger. […] Thickening of the left ventricle can also occur in genetic conditions like hypertrophic cardiomyopathy and conditions that cause protein deposits, like cardiac amyloidosis. […] Other conditions that can result in LVH include obesity, diabetes, and heart valve disease (in addition to aortic valve stenosis).
#51 Left ventricular hypertrophy | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/left-ventricular-hypertrophy?lang=us
Left ventricular hypertrophy (LVH) is present when the left ventricular mass is increased. It is a common condition, typically due to systemic hypertension, and it increases with age, obesity and severity of hypertension. […] Left ventricular hypertrophy may result from either increased pressure or volume afterload on the heart. Much more rarely it may result from genetic conditions. The relationship between obesity and left ventricular hypertrophy is complex. […] A large number of conditions can cause left ventricular hypertrophy. […] hypertension: pressure overload […] valvular heart disease […] obesity […] genetic diseases […] severe physical exercise.
#52 Causes of Left Ventricular Hypertrophy Explained – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group
https://www.acibademhealthpoint.com/causes-of-left-ventricular-hypertrophy-explained/
Obesity is now seen as a big cause of left ventricular hypertrophy (LVH). People with a high BMI often face obesity-related heart issues. This part talks about how being overweight can cause LVH. It looks at the stress on the heart and the extra work it has to do because of obesity. […] High-intensity training can change the heart in big ways. It can make it work like a sick heart. Itâs key for athletes and doctors to know the good and bad of hard training. […] Diabetes is a big problem for the heart. High blood sugar makes the heart muscle thicken. This can lead to more heart problems. […] Kidney disease is also linked to LVH. It can make the heart work too hard. This is because the kidneys canât handle fluids and blood pressure gets too high. […] LVH can happen for many reasons. These include high blood pressure, genes, and heart valve problems. Obesity, heart muscle diseases, and intense exercise can also cause it. Research from Acibadem Healthcare Group has shed light on these causes.
#53 Left Ventricular Hypertrophy – MD Searchlight
https://mdsearchlight.com/heart-health/left-ventricular-hypertrophy/
Left ventricular hypertrophy (LVH) is a medical condition where the left ventricle of your heart, which is one of its four chambers, becomes larger than usual. This enlargement can either be because the wall of the ventricle becomes thicker or because the part of the heart that holds blood gets bigger, or both. Most often, the wall of the left ventricle thickens as a reaction to extra pressure, and the chamber becomes enlarged if there’s too much volume or amount of blood. […] Several health conditions can cause the thickening of the left side of your heart, a condition known as LVH or Left Ventricular Hypertrophy. The most commonly seen causes include: 1. Essential hypertension: High blood pressure that doesn’t have an identifiable cause. 2. Renal artery stenosis: The narrowing of the arteries that carry blood to your kidneys. 3. Athletic heart with physiological LVH: An enlarged heart due to high levels of physical activity. 4. Aortic valvar stenosis: The narrowing of the heart’s aortic valve. 5. Coarctation of the aorta: A birth defect that causes narrowing in part of the aorta, the major artery carrying blood from the heart to the body. 6. Hypertrophic cardiomyopathy: A disease in which the heart muscle becomes abnormally thick. 7. Subaortic stenosis: A narrowing below the aortic valve in the heart. 8. Aortic regurgitation: Leakage of the heart’s aortic valve causes blood to flow in the wrong direction. 9. Mitral regurgitation: A condition in which the heart’s mitral valve doesn’t close tightly, allowing blood to flow backward in the heart. 10. Dilated cardiomyopathy: A condition where the heart’s ability to pump blood is lessened because the heart’s main pumping chamber, the left ventricle, is enlarged and weakened. 11. Ventricular septal defect: A birth defect that involves a hole in the wall that separates the heart’s lower chambers. 12. Infiltrative cardiac processes like Amyloidosis, Fabry disease, Danon disease: These are conditions where harmful substances build up in the heart.
#54 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Left ventricular hypertrophy (LVH) is a condition in which an increase in left ventricular mass occurs secondary to an increase in wall thickness, an increase in left ventricular cavity enlargement, or both. […] There are various clinical conditions that can lead to the development of LVH. The most common of these include the following: Essential hypertension, Renal artery stenosis, Athletic heart with physiological LVH, Aortic valvar stenosis, Coarctation of the aorta, Hypertrophic cardiomyopathy without or with outflow tract obstruction (HOCM), Subaortic stenosis (left ventricular outflow tract obstruction by muscle or membrane), Aortic regurgitation, Mitral regurgitation, Dilated cardiomyopathy, Ventricular septal defect, Infiltrative cardiac processes (e.g., Amyloidosis, Fabry disease, Danon disease).
#55 Left Ventricular Hypertrophy
https://mobile.fpnotebook.com/CV/Myocardium/LftVntrclrHyprtrphy.htm
Left Ventricular Hypertrophy, Left Ventricular Enlargement […] Secondary Hypertrophy (See Causes below) […] Causes […] Hypertension […] Valvular disease […] Aortic Stenosis […] Aortic Regurgitation […] Mitral Regurgitation […] Patent Ductus Arteriosus […] Aortic Coarctation […] Chronic Renal Failure […] Acromegaly […] Thalassemia
#56 Intern Ultrasound of the Month: Left Ventricular Hypertrophy — University Hospitals Emergency Medicine Residency
https://www.thelandofem.com/blog/2023/7/4/iusotm-left-ventricular-hypertrophy
It should be noted that LVH can be further classified as concentric or eccentric. Concentric LVH is an abnormal increase in left ventricular myocardial mass due to pressure overload from arteriolar vasoconstriction which occurs in chronic hypertension or aortic stenosis. Eccentric LVH, on the other hand, is from increased filling pressure of the left ventricle or diastolic overload. This arises from valvular regurgitation and cases of dilated cardiomyopathy.
#57 CV Physiology | Ventricular and Atrial Hypertrophy and Dilation
https://cvphysiology.com/heart-failure/hf009
An increase in the size and mass of the ventricle is referred to as ventricular hypertrophy. […] Other forms of hypertrophy are caused by ventricular remodeling in response to increased stress, such as increased pressure load (afterload). […] Hypertrophy can also result from diseases of the heart, such as valve disease and cardiomyopathies, genetic abnormalities (e.g., hypertrophic cardiomyopathy), and ischemic heart disease (coronary artery disease). […] With chronic pressure overload, as occurs with chronic hypertension or aortic valve stenosis, the ventricular chamber radius may not change; however, the wall thickness increases as new sarcomeres are added in-parallel to existing sarcomeres. […] Atria, like the ventricles, can undergo hypertrophy in response to increased afterload.
#58 Intern Ultrasound of the Month: Left Ventricular Hypertrophy — University Hospitals Emergency Medicine Residency
https://www.thelandofem.com/blog/2023/7/4/iusotm-left-ventricular-hypertrophy
It should be noted that LVH can be further classified as concentric or eccentric. Concentric LVH is an abnormal increase in left ventricular myocardial mass due to pressure overload from arteriolar vasoconstriction which occurs in chronic hypertension or aortic stenosis. Eccentric LVH, on the other hand, is from increased filling pressure of the left ventricle or diastolic overload. This arises from valvular regurgitation and cases of dilated cardiomyopathy.
#59 CV Physiology | Ventricular and Atrial Hypertrophy and Dilation
https://cvphysiology.com/heart-failure/hf009
Chronic ventricular dilation occurs in response to chronic volume overload stimulated by elevated ventricular end-diastolic pressures (e.g., as occurs in aortic and mitral regurgitation; systolic dysfunction). […] Ventricular dilation occurs as new sarcomeres are added in-series to existing sarcomeres. […] The dilated ventricle has elevated wall stress and oxygen demand, and lower mechanical efficiency. […] The atria can also undergo dilation in response to chronic volume overload. […] Hypertrophy and dilation are examples of cardiac remodeling.
#60 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#61 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#62 Left ventricular hypertrophy: An overlooked cardiovascular risk factor | MDedge
https://community.the-hospitalist.org/content/left-ventricular-hypertrophy-overlooked-cardiovascular-risk-factor
The development of myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system. Specifically, there is evidence that angiotensin II has a profibrotic effect on the myocardium of hypertensive patients. This may explain why angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are among the most potent agents for treating LVH. […] Genetics also play an important role in the pathogenesis of LVH. Mutations in genes encoding sarcomeric proteins have a direct causal relationship in patients with hypertrophic cardiomyopathy. In addition, there appears to be a genetic predisposition that causes some patients with mild hypertension to develop LVH while others do not. […] While the choice of therapy will always depend on other comorbidities, a 2003 metaanalysis of antihypertensive medications in the treatment of LVH (controlling for the degree of blood pressure lowering) showed that ARBs were the most efficacious class of agents for reducing the left ventricular mass. Specifically, ARBs decreased the mass by 13%, followed by calcium-channel blockers at 11%, ACE inhibitors at 10%, diuretics at 8%, and beta-blockers at 6%.
#63 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#64 Left ventricular hypertrophy: An overlooked cardiovascular risk factor | MDedge
https://community.the-hospitalist.org/content/left-ventricular-hypertrophy-overlooked-cardiovascular-risk-factor
The development of myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system. Specifically, there is evidence that angiotensin II has a profibrotic effect on the myocardium of hypertensive patients. This may explain why angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are among the most potent agents for treating LVH. […] Genetics also play an important role in the pathogenesis of LVH. Mutations in genes encoding sarcomeric proteins have a direct causal relationship in patients with hypertrophic cardiomyopathy. In addition, there appears to be a genetic predisposition that causes some patients with mild hypertension to develop LVH while others do not. […] While the choice of therapy will always depend on other comorbidities, a 2003 metaanalysis of antihypertensive medications in the treatment of LVH (controlling for the degree of blood pressure lowering) showed that ARBs were the most efficacious class of agents for reducing the left ventricular mass. Specifically, ARBs decreased the mass by 13%, followed by calcium-channel blockers at 11%, ACE inhibitors at 10%, diuretics at 8%, and beta-blockers at 6%.
#65 Hypertrophic cardiomyopathy – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/hypertrophic-cardiomyopathy/symptoms-causes/syc-20350198
Hypertrophic cardiomyopathy usually is caused by changes in genes that cause the heart muscle to thicken. […] If there’s no significant blocking of blood flow, the condition is called nonobstructive hypertrophic cardiomyopathy. But the heart’s main pumping chamber, called the left ventricle, might stiffen. This makes it hard for the heart to relax. The stiffness also lessens the amount of blood the ventricle can hold and send to the body with each heartbeat. […] Heart muscle cells also become arranged differently in people with hypertrophic cardiomyopathy. This is called myofiber disarray. It can trigger irregular heartbeats in some people.
#66 Hypertrophic Cardiomyopathy: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/152913-overview
Abnormally thickened intramural coronary arteries – These do not dilate normally, which leads to myocardial ischemia; this progresses to myocardial fibrosis and abnormal compensatory hypertrophy […] Subendocardial ischemia – This is related to abnormalities of the cardiac microcirculation that deplete the energy stores essential for the sequestration of calcium during diastole; subendocardial ischemia results in persistent interaction of the contractile elements during diastole and increased diastolic stiffness […] Cardiac structural abnormalities – These include a catenoid configuration of the septum, which results in myocardial cell hypertrophy and disarray.
#67
https://journals.lww.com/cardiovascularpharm/abstract/1993/21002/etiology,_pathophysiology,_and_treatment_of_left.10.aspx
Left ventricular hypertrophy (LVH), a common finding in hypertensive patients, has emerged as one of the most potent risk factors for future cardiovascular mortality in patients with hypertension. […] The reasons for reduced reserve coronary flow reserve are complex and include structural and functional abnormalities of myocardial blood vessels such as reduced capillary density, reduced luminal diameter of intramyocardial small arteries, and increased vascular tone, possibly as a result of factors such as abnormal endothelium-dependent relaxation. […] Severe hypertensive patients would be expected to achieve the greatest benefit, because, if left untreated, this group has nearly 20% mortality within 2 years.
#68 Left Ventricular Hypertrophy – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK557534/
Hypertension and aortic valve stenosis are the most common causes of LVH. In both of these conditions, the heart is contracting against an elevated afterload. […] Another cause is increased filling of the left ventricle inducing diastolic overload, which is the underlying mechanism for eccentric LVH in patients with regurgitant valvular lesions such as aortic regurgitation or mitral regurgitation and also seen in dilated cardiomyopathy. […] Coronary artery disease has been demonstrated to play a role in the pathogenesis of LVH, as the normal myocardium tries to compensate for tissue that has become ischemic or infarcted. […] Myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system (RAAS). Evidence has been established that angiotensin II produces a profibrotic effect in the myocardial tissue of hypertensive patients. […] Genomics may also play a significant role in the pathogenesis of LVH. Mutated genes that encode proteins of the sarcomere have a direct etiologic relationship in patients who present with hypertrophic cardiomyopathy.
#69 Left ventricular hypertrophy: An overlooked cardiovascular risk factor | MDedge
https://community.the-hospitalist.org/content/left-ventricular-hypertrophy-overlooked-cardiovascular-risk-factor
Left ventricular hypertrophy (LVH) strongly predicts cardiovascular morbidity and overall mortality in hypertensive patients. Antihypertensive treatment that causes LVH to regress decreases the rates of adverse cardiovascular events and improves survival, independent of how much the blood pressure is lowered. It is clinically important to recognize that LVH is a modifiable risk factor and that management is more complex than just blood pressure control. […] A CHRONICALLY ELEVATED CARDIAC WORKLOAD CAUSES LVH […] LVH is an abnormal increase in the mass of the left ventricular myocardium caused by a chronically increased workload on the heart. This most commonly results from the heart pumping against an elevated afterload, as in hypertension and aortic stenosis. Another notable cause is increased filling of the left ventricle (ie, diastolic overload), which is the underlying mechanism for LVH in patients with aortic or mitral regurgitation and dilated cardiomyopathy. Coronary artery disease can also play a role in the pathogenesis of LVH, as the normal myocardium attempts to compensate for the ischemic or infarcted tissue.
#70 The etiology of cardiac hypertrophy in infants | Scientific Reports
https://www.nature.com/articles/s41598-021-90128-3
This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. […] An underlying cause of CH was identified in two-thirds (n=47). Most common etiologies of CH were malformation syndromes (n=23, including Noonan n=12) and maternal diabetes mellitus (n=13). […] In half of the identified causes (n=22) an association with hyperinsulinism was described, including maternal diabetes mellitus (n=13), malformation syndromes with insulin resistance (n=6) and congenital hyperinsulinism (n=3). […] Nowadays, an etiology of CH can be identified in the majority of infants. The development of CH is often associated with hyperinsulinism which is mainly characterized by focal hypertrophy of the IVS on echocardiography.
#71 The etiology of cardiac hypertrophy in infants | Scientific Reports
https://www.nature.com/articles/s41598-021-90128-3
This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. […] An underlying cause of CH was identified in two-thirds (n=47). Most common etiologies of CH were malformation syndromes (n=23, including Noonan n=12) and maternal diabetes mellitus (n=13). […] In half of the identified causes (n=22) an association with hyperinsulinism was described, including maternal diabetes mellitus (n=13), malformation syndromes with insulin resistance (n=6) and congenital hyperinsulinism (n=3). […] Nowadays, an etiology of CH can be identified in the majority of infants. The development of CH is often associated with hyperinsulinism which is mainly characterized by focal hypertrophy of the IVS on echocardiography.
#72 The etiology of cardiac hypertrophy in infants | Scientific Reports
https://www.nature.com/articles/s41598-021-90128-3
The etiology of CH in young childhood is diverse and the mechanisms of development and the distribution of etiologies in young children are supposedly different from CH developing later in childhood. […] Known underlying causes of CH in infants include malformation syndromes (like Noonan), metabolic diseases (mitochondrial disorders and storage diseases such as Pompe), sarcomeric diseases (mutations in cardiac sarcomeric contractile protein genes MYH7, MYBPC3) and neuromuscular disorders (such as Friedreich ataxia). […] In our recent literature review we already emphasized the importance to additionally consider hyperinsulinism in the differential diagnosis as hyperinsulinism is widely associated with CH. […] In half of the identifiable causes of CH an association with hyperinsulinism was described including maternal diabetes mellitus (n=13), malformation syndromes (Costello n=2, Beckwith-Wiedeman n=1, Leprechaunism n=1, Berardinelli-Seip Congenital Lipodystrophy n=2) and congenital hyperinsulinism (n=3).
#73 The etiology of cardiac hypertrophy in infants | Scientific Reports
https://www.nature.com/articles/s41598-021-90128-3
This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. […] An underlying cause of CH was identified in two-thirds (n=47). Most common etiologies of CH were malformation syndromes (n=23, including Noonan n=12) and maternal diabetes mellitus (n=13). […] In half of the identified causes (n=22) an association with hyperinsulinism was described, including maternal diabetes mellitus (n=13), malformation syndromes with insulin resistance (n=6) and congenital hyperinsulinism (n=3). […] Nowadays, an etiology of CH can be identified in the majority of infants. The development of CH is often associated with hyperinsulinism which is mainly characterized by focal hypertrophy of the IVS on echocardiography.
#74 Left ventricular hypertrophy – Wikipedia
https://en.wikipedia.org/wiki/Left_ventricular_hypertrophy
Primary disease of the muscle of the heart that cause LVH are known as hypertrophic cardiomyopathies, which can lead into heart failure. […] Long-standing mitral insufficiency also leads to LVH as a compensatory mechanism. […] LV mass increases with ageing. […] Associated genes include OGN, osteoglycin.
#75 Left Ventricular Hypertrophy Symptoms/Causes – Orange County
https://www.hoag.org/specialties-services/heart-vascular/specialty-programs/heart-failure-program/conditions/left-ventricular-hypertrophy/
The aortic valve can sometimes become narrowed, a condition called aortic stenosis. This condition can require the heart muscle to work harder to force blood through this narrowed opening, which can thicken the left ventricle walls. […] Congenital heart defects are issues with the structure of the heart or heart valves that are present at birth. […] In rare cases, intense athletic training can increase the thickness of the left ventricle walls. […] There are a number of other medical conditions that can make the heart work harder and result in LVH. […] If left untreated, left ventricular hypertrophy can increase the risk of serious complications and symptoms, including serious heart disease or even death. […] Women are more likely than men to develop left ventricular hypertrophy.
#76 Hypertrophic Cardiomyopathy: Causes, Symptoms & Treatments
https://my.clevelandclinic.org/health/diseases/17116-hypertrophic-cardiomyopathy
What causes hypertrophic cardiomyopathy (HCM)? There are several potential causes of hypertrophic cardiomyopathy, including: […] Genetics. You can inherit hypertrophic cardiomyopathy from your parents and pass it on to your children. This means something is wrong with a gene that codes the characteristics of the heart muscle. There are many genes that can cause hypertrophic cardiomyopathy. When a gene defect is present, the type of hypertrophic cardiomyopathy that develops varies greatly within the family. Some people who have the hypertrophic cardiomyopathy gene may never develop the disease. […] High blood pressure. […] Aging. […] Sometimes the cause of hypertrophic cardiomyopathy is unknown.
#77 Left Ventricular Hypertrophy: Etiology-Based Therapeutic Options – PubMed
https://pubmed.ncbi.nlm.nih.gov/35353354/
Determining the etiologies of left ventricular hypertrophy (LVH) can be challenging due to the similarities of the different manifestations in clinical presentation and morphological features. […] Frequent causes of hypertrophy include etiologies due to pressure/volume overload, such as systemic hypertension, hypertrophic cardiomyopathy, or infiltrative cardiac processes such as amyloidosis, Fabry disease, and sarcoidosis. […] Hypertension and aortic valve stenosis are the most common causes of LVH.
#78
https://link.springer.com/article/10.1007/s40119-022-00260-y
Determining the etiologies of left ventricular hypertrophy (LVH) can be challenging due to the similarities of the different manifestations in clinical presentation and morphological features. […] Frequent causes of hypertrophy include etiologies due to pressure/volume overload, such as systemic hypertension, hypertrophic cardiomyopathy, or infiltrative cardiac processes such as amyloidosis, Fabry disease, and sarcoidosis. Hypertension and aortic valve stenosis are the most common causes of LVH. […] Management of LVH involves lifestyle changes, medications, surgery, and implantable devices. […] Left ventricular hypertrophy (LVH) is a condition in which there is an increase in LV mass (LVM) secondary to an increase in wall thickness, an increase in LV cavity enlargement, or both. […] Multiple comorbidities have been identified which can play an independent or synergistic role in the phenotype of the disease. The frequent causes of hypertrophy are listed in Table 1.
#79 Differential diagnosis of common etiologies of left ventricular hypertrophy using a hybrid CNN-LSTM model | Scientific Reports
https://www.nature.com/articles/s41598-022-25467-w
Differential diagnosis of left ventricular hypertrophy (LVH) is often obscure on echocardiography and requires numerous additional tests. […] LVH is most commonly a physiologic consequence of increased afterload by hypertension (i.e. hypertensive heart disease [HHD]). However, some patients demonstrate hypertrophied myocardium without an increased afterload; the differential diagnosis in such patients includes hypertrophic cardiomyopathy (HCM) and infiltrative cardiomyopathy, such as light-chain cardiac amyloidosis (ALCA). […] The differential diagnosis of LVH requires a series of expensive, invasive, and time-consuming procedures, such as cardiac magnetic resonance imaging (CMR), endomyocardial biopsy (EMB), and genetic testing. […] The differential diagnosis between these conditions is important because of differences in the treatment and prognosis. While the management of HHD mainly focuses on blood pressure control, the management of HCM and ALCA is much more complex and multifactorial.
#80 Differential diagnosis of common etiologies of left ventricular hypertrophy using a hybrid CNN-LSTM model | Scientific Reports
https://www.nature.com/articles/s41598-022-25467-w
Differential diagnosis of left ventricular hypertrophy (LVH) is often obscure on echocardiography and requires numerous additional tests. […] LVH is most commonly a physiologic consequence of increased afterload by hypertension (i.e. hypertensive heart disease [HHD]). However, some patients demonstrate hypertrophied myocardium without an increased afterload; the differential diagnosis in such patients includes hypertrophic cardiomyopathy (HCM) and infiltrative cardiomyopathy, such as light-chain cardiac amyloidosis (ALCA). […] The differential diagnosis of LVH requires a series of expensive, invasive, and time-consuming procedures, such as cardiac magnetic resonance imaging (CMR), endomyocardial biopsy (EMB), and genetic testing. […] The differential diagnosis between these conditions is important because of differences in the treatment and prognosis. While the management of HHD mainly focuses on blood pressure control, the management of HCM and ALCA is much more complex and multifactorial.
#81 Differential diagnosis of common etiologies of left ventricular hypertrophy using a hybrid CNN-LSTM model | Scientific Reports
https://www.nature.com/articles/s41598-022-25467-w
Although the underlying LVH pathophysiology differs between HHD (increased afterload), HCM (sarcomere mutation and myofibril disarray/disorganization), and ALCA (amyloid protein infiltration), the differential diagnosis is often difficult on echocardiography. […] The difficulties in the differential diagnosis on echocardiography leads to the subsequent use of numerous noninvasive and invasive tests, such as CMR, EMB, and genetic testing. […] In the present study, we developed a deep learning algorithm for the differential diagnosis of common LVH etiologies (HHD, HCM, and ALCA) by applying a hybrid CNN-LSTM model and aggregate network to standard echocardiographic images. The high diagnostic performance of our deep learning algorithm suggests that the use of deep learning can improve the diagnostic process in patients with LVH.
#82 Differential diagnosis of common etiologies of left ventricular hypertrophy using a hybrid CNN-LSTM model | Scientific Reports
https://www.nature.com/articles/s41598-022-25467-w
Although the underlying LVH pathophysiology differs between HHD (increased afterload), HCM (sarcomere mutation and myofibril disarray/disorganization), and ALCA (amyloid protein infiltration), the differential diagnosis is often difficult on echocardiography. […] The difficulties in the differential diagnosis on echocardiography leads to the subsequent use of numerous noninvasive and invasive tests, such as CMR, EMB, and genetic testing. […] In the present study, we developed a deep learning algorithm for the differential diagnosis of common LVH etiologies (HHD, HCM, and ALCA) by applying a hybrid CNN-LSTM model and aggregate network to standard echocardiographic images. The high diagnostic performance of our deep learning algorithm suggests that the use of deep learning can improve the diagnostic process in patients with LVH.
#83 The Importance of Determining the Etiology of Left Ventricular Hypertrophy | CheckRare
https://checkrare.com/the-importance-of-determining-the-etiology-of-left-ventricular-hypertrophy/
John Jefferies, MD, of the University of Tennessee Health Science Center, discusses the importance of determining the etiology of left ventricular hypertrophy (LVH) to determine if it is a genetic problem (such as Fabry disease). […] As Dr. Jefferies explains, LVH is a common problem but it is also a common symptom in Fabry disease. Therefore, it is important for cardiologists to determine the cause of LVH. In most cases, it is due uncontrolled hypertension or kidney disease. However, if the cause is Fabry disease, then treatment can be geared towards enzyme replacement therapy to address the etiology of the cardiomyopathy.
#84
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abr9384
Left ventricular hypertrophy (LVH) means that the muscle of the heart’s main pump (left ventricle) has become thick and enlarged. This can happen over time if the left ventricle has to work too hard. […] LVH is usually caused by high blood pressure. It may also be caused by a heart problem, such as hypertrophic cardiomyopathy or a heart valve problem like aortic valve stenosis. […] LVH is linked to an increased risk of other problems, including heart attack, heart failure, stroke, and heart rhythm problems. Treatment can help reduce these risks. […] The best treatment will depend on what caused LVH. For many people, the focus will be on treating high blood pressure. Getting high blood pressure under control may keep LVH from getting worse. This can help prevent heart failure. It can also help lower the risk of heart attack and stroke. […] If LVH was caused by a heart problem, you may have other treatment options. Treatment may help lower your risk of heart failure and other serious problems.
#85
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abr9384
Left ventricular hypertrophy (LVH) means that the muscle of the heart’s main pump (left ventricle) has become thick and enlarged. This can happen over time if the left ventricle has to work too hard. […] LVH is usually caused by high blood pressure. It may also be caused by a heart problem, such as hypertrophic cardiomyopathy or a heart valve problem like aortic valve stenosis. […] LVH is linked to an increased risk of other problems, including heart attack, heart failure, stroke, and heart rhythm problems. Treatment can help reduce these risks. […] The best treatment will depend on what caused LVH. For many people, the focus will be on treating high blood pressure. Getting high blood pressure under control may keep LVH from getting worse. This can help prevent heart failure. It can also help lower the risk of heart attack and stroke. […] If LVH was caused by a heart problem, you may have other treatment options. Treatment may help lower your risk of heart failure and other serious problems.
#86
https://link.springer.com/article/10.1007/s40119-022-00260-y
Determining the etiologies of left ventricular hypertrophy (LVH) can be challenging due to the similarities of the different manifestations in clinical presentation and morphological features. […] Frequent causes of hypertrophy include etiologies due to pressure/volume overload, such as systemic hypertension, hypertrophic cardiomyopathy, or infiltrative cardiac processes such as amyloidosis, Fabry disease, and sarcoidosis. Hypertension and aortic valve stenosis are the most common causes of LVH. […] Management of LVH involves lifestyle changes, medications, surgery, and implantable devices. […] Left ventricular hypertrophy (LVH) is a condition in which there is an increase in LV mass (LVM) secondary to an increase in wall thickness, an increase in LV cavity enlargement, or both. […] Multiple comorbidities have been identified which can play an independent or synergistic role in the phenotype of the disease. The frequent causes of hypertrophy are listed in Table 1.
#87 Left ventricular hypertrophy: An overlooked cardiovascular risk factor | MDedge
https://community.the-hospitalist.org/content/left-ventricular-hypertrophy-overlooked-cardiovascular-risk-factor
The development of myocardial fibrosis appears to be pathophysiologically linked to the renin-angiotensin-aldosterone system. Specifically, there is evidence that angiotensin II has a profibrotic effect on the myocardium of hypertensive patients. This may explain why angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are among the most potent agents for treating LVH. […] Genetics also play an important role in the pathogenesis of LVH. Mutations in genes encoding sarcomeric proteins have a direct causal relationship in patients with hypertrophic cardiomyopathy. In addition, there appears to be a genetic predisposition that causes some patients with mild hypertension to develop LVH while others do not. […] While the choice of therapy will always depend on other comorbidities, a 2003 metaanalysis of antihypertensive medications in the treatment of LVH (controlling for the degree of blood pressure lowering) showed that ARBs were the most efficacious class of agents for reducing the left ventricular mass. Specifically, ARBs decreased the mass by 13%, followed by calcium-channel blockers at 11%, ACE inhibitors at 10%, diuretics at 8%, and beta-blockers at 6%.