Left ventricular hypertrophy

Prevalence of LVH is 6% under the age of 30 years and increases to 43% in those over 70 years old.

Prevalence varies with hypertension, ranging from under 20% in mild hypertension to greater than 50% in patients with severe hypertension.

The most common cause of left ventricular wall thickening is hypertensive heart disease, which develops with long-standing poorly controlled hypertension.

Patients with hypertension have concentric left ventricular hypertrophy, eccentric hypertrophy, or concentric remodeling in the left ventricle.

Left ventricle wall thickening associated with hypertension is reversible.

Left ventricle wall thickening can be associated with athletic training with increased left ventricular diameter, wall tickness, and mass associated with normal systolic and diastolic function was sinus bradycardia.

Left ventricular thickness of 13 mm or  greater  is uncommon in athletes.

left ventricular wall thickness typically decreases with decreased train although the heart may remain in large in some athletes.

Harbinger of future cardiovascular morbidity and mortality.

Left ventricular hypertrophy can be caused by aortic stenosis, or aortic coarctation.

Of all modifiable risk factors, it is the strongest predictor of an adverse outcome in hypertension.

ACE inhibitors are the most effective class of agents for reversing LVH.

A major risk factor for heart failure, arrhythmias and sudden death.

Reducing blood pressure can cause regression in LVH and decrease cardiovascular morbidity and mortality.

All types of LVH associated with diastolic abnormalities.

Present in 75% of patients with end-stage real disease, and on dialysis (Foley RN).

When cardiac hypertrophy reaches its limit beyond which muscle mass is not able to compensate for the increased burden cardiac failure occurs.

At the extreme of hypertrophy degeneration of the myocardial fibers and loss of myofibrillar contractile elements.

Correlations of left ventricular mass and ECG voltage are weak in male athletes, so ECG is not useful in screening for LVH in athletes.

Various inherited systemic disorders are associated with myocardial hypertrophy; Noonan’s syndrome, mitochondrial myopathies, Friedrichs ataxia, glycogen storage disease type III lysosomal storage disorders, Damon’s disease, Pompe’s disease, mucopolysaccharidosis, Fabry’s disease.

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