Modern opportunities for assessing the left ventricle remodeling
DOI:
https://doi.org/10.14739/2310-1210.2023.4.277403Keywords:
left ventricular geometry, ventricular remodeling, left ventricular hypertrophy, echocardiographyAbstract
Aim: To compare the results of distributing left ventricular (LV) remodeling patterns according to two classifications and identify their advantages and disadvantages.
Materials and methods. The study involved 2019 patients, aged from 18 to 94 years with a mean of 57.6 ± 16.4 years, 51 % males, apparently healthy and with cardiovascular and respiratory system pathology. Echocardiography was performed using an Esaote MyLab Seven device (Italy) according to generally accepted standards. The distribution of patients according to four classic LV remodeling patterns and according to the classification proposed by W. Gaasch and M. Zile was studied. Statistical analysis was performed using Statistica for Windows 13.0 (StatSoft Inc., USA; license No. JPZ804I382130ARCN10-J). Qualitative variables were given as absolute and relative frequency (n (%)).
Results. The distribution of patients according to 4 classic LV remodeling patterns was as follows: 53.0 % had normal LV geometry; 10.2 % – concentric remodeling; 15.6 % – concentric hypertrophy; 21.2 % – eccentric hypertrophy. At the same time, in the group of normal LV geometry, 25.2 % of people had LV dilatation. When distributing the patients by remodeling patterns according to the W. Gaasch and M. Zile classification, the following data were obtained: 26.9 % of people had normal LV geometry, concentric remodeling – 10.2 %, concentric hypertrophy – 12.4 %, mixed hypertrophy – 3.1 %, physiological and dilated hypertrophy – 11.8 %, eccentric hypertrophy – 5.5 %, eccentric remodeling – 11.4 %. In addition, 3 more groups of patients were formed, who did not have a terminological definition based on the W. Gaasch and M. Zile classification and, in total, accounted for 18.6 % of the examined.
Conclusions. The missing options of dilated left ventricle should be recognized as a limitation of the classic classifications of left ventricular remodeling patterns. The imposition of additional criteria covering the cavity dilatation in determining the left ventricular remodeling patterns improves the assessment of the patient’s prognosis and contributes to a more individual selection of pathogenetic therapy.
References
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., Lip, G. Y. H., … ESC Scientific Document Group (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. European heart journal, 39(33), 3021-3104. https://doi.org/10.1093/eurheartj/ehy339
Lieb, W., Gona, P., Larson, M. G., Aragam, J., Zile, M. R., Cheng, S., Benjamin, E. J., & Vasan, R. S. (2014). The natural history of left ventricular geometry in the community: clinical correlates and prognostic significance of change in LV geometric pattern. JACC. Cardiovascular imaging, 7(9), 870-878. https://doi.org/10.1016/j.jcmg.2014.05.008
Bastos, M. B., Burkhoff, D., Maly, J., Daemen, J., den Uil, C. A., Ameloot, K., Lenzen, M., Mahfoud, F., Zijlstra, F., Schreuder, J. J., & Van Mieghem, N. M. (2020). Invasive left ventricle pressure-volume analysis: overview and practical clinical implications. European heart journal, 41(12), 1286-1297. https://doi.org/10.1093/eurheartj/ehz552
Hendriks, T., Said, M. A., Janssen, L. M. A., van der Ende, M. Y., van Veldhuisen, D. J., Verweij, N., & van der Harst, P. (2019). Effect of Systolic Blood Pressure on Left Ventricular Structure and Function: A Mendelian Randomization Study. Hypertension, 74(4), 826-832. https://doi.org/10.1161/HYPERTENSIONAHA.119.12679
Fabiani, I., Pugliese, N. R., La Carrubba, S., Conte, L., Antonini-Canterin, F., Colonna, P., Benedetto, F., Calogero, E., Barletta, V., Carerj, S., Buralli, S., Taddei, S., Romano, M. F., Di Bello, V., & Italian Society of Cardiovascular Echography (SIEC) (2017). Incremental prognostic value of a complex left ventricular remodeling classification in asymptomatic for heart failure hypertensive patients. Journal of the American Society of Hypertension : JASH, 11(7), 412-419. https://doi.org/10.1016/j.jash.2017.05.005
Syvolap, V. D., & Kapshytar, N. I. (2019). Predictors of the adverse course at hospital stage of Q-myocardial infarction treatment. Modern Medical Technology, (3), 56-63. https://doi.org/10.34287/MMT.3(42).2019.11
Bang, C. N., Gerdts, E., Aurigemma, G. P., Boman, K., de Simone, G., Dahlöf, B., Køber, L., Wachtell, K., & Devereux, R. B. (2014). Four-group classification of left ventricular hypertrophy based on ventricular concentricity and dilatation identifies a low-risk subset of eccentric hypertrophy in hypertensive patients. Circulation. Cardiovascular imaging, 7(3), 422-429. https://doi.org/10.1161/CIRCIMAGING.113.001275
Tadic, M., Cuspidi, C., Saeed, S., Lazic, J. S., Vukomanovic, V., Grassi, G., Sala, C., & Celic, V. (2022). The influence of left ventricular geometry on myocardial work in essential hypertension. Journal of human hypertension, 36(6), 524-530. https://doi.org/10.1038/s41371-021-00543-2
Taamallah, K., Besbes, B., Raddaoui, H., Hajlaoui, N., Lahidheb, D., & Fehri, W. (2021). Is there a latent left ventricular dysfunction in hypertensive patients with preserved ejection fraction?. La Tunisie medicale, 99(4), 456-465.
Marwick, T. H., Gillebert, T. C., Aurigemma, G., Chirinos, J., Derumeaux, G., Galderisi, M., Gottdiener, J., Haluska, B., Ofili, E., Segers, P., Senior, R., Tapp, R. J., & Zamorano, J. L. (2015). Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE)†. European heart journal. Cardiovascular Imaging, 16(6), 577-605. https://doi.org/10.1093/ehjci/jev076
Gaasch, W. H., & Zile, M. R. (2011). Left ventricular structural remodeling in health and disease: with special emphasis on volume, mass, and geometry. Journal of the American College of Cardiology, 58(17), 1733-1740. https://doi.org/10.1016/j.jacc.2011.07.022
Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., Picard, M. H., Roman, M. J., Seward, J., Shanewise, J. S., Solomon, S. D., Spencer, K. T., Sutton, M. S., Stewart, W. J., Chamber Quantification Writing Group, American Society of Echocardiography's Guidelines and Standards Committee, & European Association of Echocardiography (2005). Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. Journal of the American Society of Echocardiography, 18(12), 1440-1463. https://doi.org/10.1016/j.echo.2005.10.005
Zheng, Q., Loo, G., Le, T.-T., Shi, L., Chan, E. S.-Y., & Chin, C. W. L. (2019). Prognosis associated with geometric patterns of left ventricular remodeling: systematic review and network meta-analysis. F1000Research, 8, 1130. https://doi.org/10.12688/f1000research.19907.1
Goh, V. J., Le, T. T., Bryant, J., Wong, J. I., Su, B., Lee, C. H., Pua, C. J., Sim, C. P. Y., Ang, B., Aw, T. C., Cook, S. A., & Chin, C. W. L. (2017). Novel Index of Maladaptive Myocardial Remodeling in Hypertension. Circulation. Cardiovascular imaging, 10(9), e006840. https://doi.org/10.1161/CIRCIMAGING.117.006840
Garg, S., de Lemos, J. A., Ayers, C., Khouri, M. G., Pandey, A., Berry, J. D., Peshock, R. M., & Drazner, M. H. (2015). Association of a 4-Tiered Classification of LV Hypertrophy With Adverse CV Outcomes in the General Population. JACC. Cardiovascular imaging, 8(9), 1034-1041. https://doi.org/10.1016/j.jcmg.2015.06.007
Cuspidi, C., Facchetti, R., Bombelli, M., Sala, C., Tadic, M., Grassi, G., & Mancia, G. (2016). Prevalence and correlates of new-onset left ventricular geometric abnormalities in a general population: the PAMELA study. Journal of hypertension, 34(7), 1423-1431. https://doi.org/10.1097/HJH.0000000000000956
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
