LEFT-VENTRICULAR GEOMETRY AS AN INDEPENDENT PREDICTOR FOR EXTRACARDIAC TARGET ORGAN DAMAGE IN ESSENTIAL-HYPERTENSION

Left ventricular hypertrophy (LVH) is an independent cardiovascular ri sk factor. It has not been established, however, whether left ventricu lar geometry is an independent predictor of extracardiac target organ damage in essential hypertension. Study groups were classified accordi ng to relative wall thickness: 27 patients with concentric LVH and 50 patients with eccentric LVH. Age and left ventricular mass indexes of two groups were matched. As indexes of extracardiac target organ damag e, retinal funduscopic grade, and serum creatinine level were measured . The severity of hypertensive retinopathy and the renal involvement w ere more severe in patients with concentric LVH than in patients with eccentric LVH. Extracardiac target organ damage was consistently highe r in patients with concentric LVH than in those with eccentric LVH. Sy stemic hemodynamics paralleled ventricular geometric patterns, with hi gher peripheral resistance and lower aortic compliance in patients wit h concentric LVH, whereas end-diastolic volumes and stroke volumes wer e higher in patients with eccentric LVH than in patients with concentr ic LVH. In addition, total peripheral resistance was related to retina l fundoscopic grade (r = 0.41, P <.01), and serum creatinine level (r = 0.28, P <.05). Even in the presence of an identical degree of LVH, e chocardiographically determined left ventricular geometry may provide a further independent stratification of extracardiac target organ dama ge in essential hypertension, Am J Hypertens 1998; 11:1171-1177 (C) 19 98 American Journal of Hypertension, Ltd.