ABSTRACT
Contributing factors to increased risk of LVH Several different factors have been postulated as causing or contributing to the increased risk associated with LVH (Fig. 2.1), but it is first necessary to understand the pathophysiological background to LVH. The heart hypertrophies in response to elevation in the left ventricular wall stress, which occurs as a consequence of hypertension. Cardiac muscle hypertrophy initially serves to return wall stress to normal, thus preserving left ventricular systolic function and reducing the likelihood of myocardial perfusion abnormalities. This adaptive response is limited, however. If systolic blood pressure remains elevated cardiac function and myocardial perfusion will eventually deteriorate. Despite the apparently protective role of LVH, in the long-term, it causes a number of pathophysiological abnormalities. All of which could contribute to its adverse prognostic profile.
