Cardiac Left Ventricular Hypertrophy

1. Front Matter

   Pages I-XIV

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2. Prevalence and Risks of Left Ventricular Hypertrophy

   1. Front Matter

      Pages 1-1

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   2. Epidemiologic Features of Left Ventricular Hypertrophy in Normotensive and Hypertensive Subjects

      • D. D. Savage, R. D. Abbott, S. Padgett, S. J. Anderson, R. J. Garrison

      Pages 2-15

   3. Sensitivity of Echocardiography for Detection of Left Ventricular Hypertrophy

      • R. B. Devereux, D. R. Alonso, E. M. Lutas, T. G. Pickering, G. A. Harshfield, J. H. Laragh

      Pages 16-37

   4. Determinants and Modulators of Left Ventricular Structure

      • F. H. Messerli

      Pages 38-50

3. Etiology and Functional Aspects at the Cellular Level

   1. Front Matter

      Pages 51-51

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   2. Relationship Between Cardiac Work and Cardiac Growth: Some General Thoughts on Cardiac Hypertrophy

      • W. F. H. M. Mommaerts

      Pages 52-64

   3. Myocardial cell Properties and Hypertrophy

      • H. E. D. J. Keurs, B. J. M. Ter Mulder, V. J. A. Schouten

      Pages 66-88

4. Etiology and functional aspects of the hypertrophied heart

   1. Front Matter

      Pages 89-89

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   2. Some Functional Consequences of Left Ventricular Hypertrophy in Hypertension

      • R. C. Tarazi

      Pages 90-101

   3. Left Ventricular Hypertrophy, Matching Between Heart and Arterial System

      • G. Elzinga

      Pages 102-113

   4. Assessment of the Function of the Hypertrophied Heart

      • F. M. Fouad

      Pages 114-128

5. The Coronary Circulation in the Hypertrophied Heart

   1. Front Matter

      Pages 129-129

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   2. Total and Transmural Perfusion of the Hypertrophied Heart

      • J. I. E. Hoffman, M. T. Grattan, F. L. Hanley, L. M. Messina

      Pages 130-151

   3. Left Ventricular Hypertrophy and Myocardial Ischemia

      • J. J. Schipperheyn, J. Jonas

      Pages 152-169

   4. Coronary Flow Mechanics of the Hypertrophied Heart

      • J. A. E. Spaan, P. Bruinsma, J. D. Laird

      Pages 170-193

6. Diagnostic Development in Detection of Left Ventricular Hypertrophy

   1. Front Matter

      Pages 195-195

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   2. Electrocardiographic Aspects of Left Ventricular Hypertrophy

      • H. E. Kulbertus

      Pages 196-207

   3. Radioisotope Studies in Patients With Left Ventricular Hypertrophy

      • G. A. Beller

      Pages 208-222

7. Therapeutic Aspects of Left Ventricular Hypertrophy

   1. Front Matter

      Pages 223-223

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Left ventricular hypertrophy (LVH) is usually considered to be a compen­ satory adjustment of heart muscle to an inreased work load. LVH develops in the course of valvular or congenital heart disease, or when part of the myocardium is damaged by long-standing ischemia or infarction. In the hypertrophied heart the muscle fibers increase in size, not in number. The fibers are found to contain a larger number of myofibrils and the cell organelles are larger. From epidemiologic studies it is known that even mild LVH is associated with myocardial ischemia, ventricular arrhythmias, and sudden cardiac death. Most cases of LVH show focal degenerative tissue changes including cellular atrophy, myofibrillar disorganization, interstitial fibrosis, and loss of intracellular connections. Myocardial dysfunction develops and, unlike the functional adaptive changes found in pure hypertrophy, is not reversible by surgical treatment of the valvular heart disease or medical correction of hypertension. Interstitial fibrosis, intracellular changes of musc Ie cells, and loss of contract ile tissue lead to poor mechanical function and undoubtedly increase the risk of ischemia, arrhythmias, or sudden death, a well-recognized problem in patients with a variety of heart diseases. Even When successfully treated, the patients may remain at risk if the compensatory hypertrophy is not fully reversed. Epidemiologic studies conducted in the Framingham population in the early 1950' s demonstrated LVH according to electrocardiographic criteria in 1. 5% of the population; 2% of the population had LVH according to chest X-ray criteria.

• arrhythmia
• artery
• circulation
• congenital heart disease
• echocardiography
• heart
• heart disease
• hypertension
• sudden cardiac death

• Department of Cardiology, Leiden University Hospital, Leiden, The Netherlands

  H. E. D. J. Keurs, J. J. Schipperheyn

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