Hypertrophy due to left cardiac insufficiency: role of the neurohumoral system
Lerch, R.; Montessuit, C.
Praxis 86(7): 238-241
1997
ISSN/ISBN: 1661-8157 PMID: 9139340 Document Number: 480872
Left ventricular hypertrophy in patients with hypertensive heart disease is associated with impaired relaxation and myocardial interstitial fibrosis leading to enhanced filling pressure, referred to as left ventricular diastolic dysfunction. Impairment of systolic function, characterized by reduced ejection fraction occurs at a later stage. Activation of the renin-angiotensin-aldosterone system contributes to progression to heart failure by at least two mechanisms: (1) increased left ventricular loading conditions due to vasoconstriction and retention of sodium; (2) direct effects on the myocardium resulting in myocyte hypertrophy and interstitial fibrosis.