Hypertensive cardiomyopathy:A clinical approach and literature review

• 作者: Atsushi Amano Kishio Kuroda Tomoko S Kato
• 来源期刊: 世界高血压杂志
• 学科: 医学
• 关键词: HYPERTENSION Diagnosis CARDIOMYOPATHY HYPERTROPHY Risk assessment
• 年，卷（期）: 2015,（2）
• 页码范围: 41-52
• 页数: 12页
• 分类号: R

摘要

Hypertensive cardiomyopathy(HTN-CM)is a structural cardiac disorder generally accompanied by concentric left ventricular hypertrophy(LVH)associated with diastolic or systolic dysfunction in patients with persistent systemic hypertension.It occurs in the absence of other cardiac diseases capable of causing myocardial hypertrophy or cardiac dysfunction.Persistent systemic hypertension leads to structural and functional myocardial abnormalities resulting in myocardial ischemia,fibrosis,and hypertrophy.HTN-CM is predominantly a disease of impaired relaxation rather than impaired contractility,so patients are usually asymptomatic during resting conditions.However,their stiff left ventricles become incapable of handling increased blood volume and cannot produce appropriate cardiac output with the slight change of circulating volume that may occur during exercise.Importantly,the accompanying LVH is itself a risk factor for mortality and morbidity.Therefore,early detection of LVH development in patients with hypertension(referred to as HTN-CM)is critical for optimal treatment.In addition to pathological findings,echocardiography and cardiac magnetic resonance imaging are ideal tools for the diagnosis of HTN-CM.Timely diagnosis of this condition and utilization of appropriate treatment are required to improve morbidity and mortality in hypertensive patients.This review article presents an overview of the multidimensional impact of myocardial disorder in patients with hypertension.Relevant literature is highlighted and the effects of hypertension on cardiac hypertrophy and heart failure development are discussed,including possible therapeutic options.