Modern opportunities for assessing the left ventricle remodeling

Authors

DOI:

https://doi.org/10.14739/2310-1210.2023.4.277403

Keywords:

left ventricular geometry, ventricular remodeling, left ventricular hypertrophy, echocardiography

Abstract

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.

Author Biographies

V. V. Syvolap, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, PhD, DSc, Professor of the Department of Propaedeutics of Internal Medicine

A. O. Bohun, Zaporizhzhia State Medical and Pharmaceutical University, Ukraine

MD, Postgraduate student of the Department of Propaedeutics of Internal Medicine

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

Published

2023-07-20

How to Cite

1.
Syvolap VV, Bohun AO. Modern opportunities for assessing the left ventricle remodeling. Zaporozhye Medical Journal [Internet]. 2023Jul.20 [cited 2024Jul.3];25(4):292-6. Available from: http://zmj.zsmu.edu.ua/article/view/277403