Concentric Hypertrophy

[mthombare]

I found to have high BP ( 160/90) 3 days back and suggested to undergo 2D echo along with all other tests. 2D echo diagnosed LV concentric hypertrophy. My all other tests ( renal doppler, USG, LFT, cholesterol, CBC, kidney function) are normal. Last night my doctor started medicine ( 40mg of temlisartan). I am 30 year old with no family history of hypertension. I would like to know is Concentric Hypertrophy reversible? Will my LV come to normal if I follow all medicines and take all precautions. Manoj, India.

[kenkeith]

Concentric hypertrophy involves thickness of the heart walls, the chamber radius may not change.  The underlying cause for this condition is a heart that has been overworked due to high blood pressure (usually).  

This type of ventricle is capable of generating greater forces and higher pressures, while the increased wall thickness maintains normal wall stress. This type of ventricle becomes "stiff"  which can impair filling and lead to diastolic dysfunction (less blood pumped with each heartbeat.)   If untreated the heart could lose its contrractility and cause systolic dysfunction.  

Reduce the heart's workload with an ACE inhibitor and/or beta blocker for high blood pressure can be helpful and slow any progression.  Time will tell if the heart walls can be reduced to normal size and normal filling capacity.  Often when the wall become stiff there has been a physical change of heart muscle cells and not reversible.  An athlete's heart has the same heart wall cell characteristic, but the physiology of the cells' change  is different and an athlete's heart can return to normal.

If you have an EF (50 to 70%, amount of blood pumped with each heartbeat), that would be a good indicator of little damage, also heart wall dimensions (left ventricle) from your test would also be helpful.