Left Ventricular Hypertrophy

The importance of left ventricular hypertrophy in cardiovascular disease has gained wide recognition. Left ventricular hypertrophy is a highly important risk factor associated with major cardiovascular events, including symptomatic heart failure, particularly in patients with systemic hypertension. Over the past years much has been learned about the genetics, molecular background, prevalence, incidence and prognosis of left ventricular hypertrophy. A variety of noninvasive methods has emerged for detecting left ventricular hypertrophy and the assessment of reversal of hypertrophy. Yet, a lot of controversy remains about the connotations and clinical implications of left ventricular hypertrophy. For instance, in the athlete's heart left ventricular hypertrophy may constitute a physiological adaptation to pressure overload, which normalizes following discontinuation of strenuous physical activity. On the other hand, in particular in patients with hypertension, left ventricular hypertrophy denotes a serious prognosis in the course of hypertension. In these patients left ventricular hypertrophy should be regarded as a grave prognostic sign rather than an innocent compensatory phenomenon. The distinction between physiologic and pathophysiologic left ventricular hypertrophy has been the basis for this book.

Klappentext

The importance of left ventricular hypertrophy (LVH) in cardiovascular disease has gained wide recognition. LVH is a highly important risk factor associated with major cardiovascular events, including symptomatic heart failure, particularly in patients with systemic hypertension. In recent years much has been learned about the genetics, molecular background, prevalence, incidence and prognosis of LVH. A variety of noninvasive methods has emerged for detecting LVH and the assessment of reversal of hypertrophy, yet a lot of controversy remains about the connotations and clinical implications of LVH. For instance, in the athlete's heart LVH may constitute a physiological adaptation to pressure overload, which normalizes following discontinuation of strenuous physical activity. On the other hand, in particular in patients with hypertension, LVH denotes a serious prognosis in the course of hypertension. In these patients LVH should be regarded as a grave prognostic sign rather than an innocent compensatory phenomenon. The distinction between physiologic and pathophysiologic LVH is the basis for this book. Left Ventricular Hypertrophy - Physiology versus Pathology is a bibliographical reflection of a Boerhaave Symposium held on April 9, 1999, in Leiden, The Netherlands. At this symposium the major issues in dealing with LVH were discussed, including etiology, genetics, detection, and therapy. In particular, the book includes novel detection methods for LVH such as magnetic resonance imaging and spectroscopy. Furthermore, much attention was paid to the molecular and genetic approach of LVH. This book will assist clinical cardiologists, fellows in cardiology, general internists, radiologists, cardiothoracic surgeons, biochemists, physiologists, pharmacologists, and basic research fellows in understanding the most recent insights in the background of physiologic versus pathologic LVH.

Zusammenfassung
`This book presents an excellent overview of today's understanding of left ventricular hypertrophy and the research directions that are being pursued. It is therefore of great value for all medical specialists and basic scientists who are interested in this field.'
Johan H.C. Reiber in International Journal of Cardiac Imaging, 16 (2000)

Inhalt
1 Etiology of left ventricular hypertrophy.- 2 The role of vascular failure in heart failure.- 3 Perfusion abnormalities in the hypertrophied left ventricle: Link between compensated hypertrophy and heart failure?.- 4 Assessment of left ventricular hypertrophy: a comparison of electrocardiography, echocardiography and magnetic resonance imaging.- 5 Hypertrophy and hypertension.- 6 Left ventricular hypertrophy: pathology versus physiology.- 7 The athlete's heart: a physiological or a pathological phenomenon?.- 8 Left ventricular hypertrophic heart disease studied by MR imaging and 31P-MR spectroscopy.- 9 Hypertrophy and arrhythmias.- 10 Left ventricular hypertrophy: reversal by antihypertensive therapy.- 11 Postoperative regression of left ventricular hypertrophy.- 12 Myocardial hypertrophy and failure: a molecular approach.- 13 Hypertrophy: clinical relevance of genotype. Einthoven lecture 1999.