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Assessment of hypertrophy and regression in arterial hypertension: Value of magnetic resonance Imaging

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Cardiovascular Nuclear Medicine and MRI

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 128))

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Summary

Increasing interest has been paid to the effects of antihypertensive treatment on the myocardium. In particular regression of left ventricular hypertrophy (LVH) has been the focus of recent studies. Regression of LVH can be decisive in improving oxygen consumption of the myocardium and may prevent serious long-term cardiac complications of hypertension, such as dilatation of tissue structures and heart failure. Regression of hypertrophy under antihypertensive treatment was first demonstrated in rats. Marked regression was observed after alpha-methyldopa, beta-blocking agents, and angiotensin converting enzyme (ACE) inhibitors. Effects of diuretics and direct vasodilators like hydralazine and minoxidil were less impressive. In patients with hypertension, cardiologists first made use of echocardiography for the direct in vivo demonstration of regression of hypertrophy. Previous to echocardiography, only indirect electrocardiographic methods were available. With echocardiography, antihypertensive drugs such as alphamethyldopa, beta-blocking agents, and ACE-inhibitors showed similar effects on LVH as observed in rats. Thallium-201 perfusion imaging for quantification of hypertrophy has been shown useful for demonstration of L VH, but the radionuclide technique lacks the spatial resolution to accurately determine regression of L VH. Magnetic resonance imaging (MRI) has emerged as a new imaging modality the heart since 1983. Due to its high spatial resolution, MRI is an excellent technique for assessing cardiac dimensions, volumes and myocardial mass. MRI is therefore very suitable to determine changes in these myocardial parameters before and after antihypertensive treatment.

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  1. Hermann Eichstaedt
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Editors and Affiliations

  1. Department of Diagnostic Radiology and Nuclear Medicine, University Hospital Leiden, Leiden, The Netherlands

    Johan H. C. Reiber

  2. Department of Cardiology, University Hospital Leiden, Leiden, The Netherlands

    Ernst E. Van Der Wall

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Eichstaedt, H. (1992). Assessment of hypertrophy and regression in arterial hypertension: Value of magnetic resonance Imaging. In: Reiber, J.H.C., Van Der Wall, E.E. (eds) Cardiovascular Nuclear Medicine and MRI. Developments in Cardiovascular Medicine, vol 128. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-2666-3_23

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