Do We Need to Know the Left Ventricular Geometry Patterns of the Brazilian Population?

In this issue of the Arquivos Brasileiros de Cardiologia, Almeida et al. describe the left ventricular (LV) remodeling patterns frequencies found in a Brazilian population followed at primary healthcare clinics in Niterói city, state of Rio de Janeiro. The authors found that a LV abnormal geometry was present in up to 33% of 636 studied individuals (mean age 59.5±10.3 years old; 62% women). Eccentric LV hypertrophy (LVH) was the most common abnormal LV geometry pattern (29%), followed by concentric LVH and concentric remodeling (2% each).

LV remodeling is no longer considered solely an adaptative mechanism but a response to several different stimuli that lead to gene activation, cellular hypertrophy, apoptosis, fibrosis, and, finally, LV remodeling with different degrees of LV function compromise and increase in cardiovascular risk. In fact, the relation between LVH diagnosed by electrocardiogram and mortality has been long recognized. LV mass is considered an independent risk factor for heart failure (HF),^, stroke, sudden cardiac death, supraventricular and ventricular tachycardia, and all-cause and cardiovascular mortality. Therefore, hypertension (HTN) is considered stage A HF and LVH is considered stage B HF on the American College of Cardiology/American Heart Association guidelines on HF management. Surprisingly, it was not up to the study of Almeida et al. that LV geometry patterns were studied in Brazilian population. We need to know exactly what are the frequency and value of LV geometry patterns in the Brazilian population and not only apply knowledge obtained with other populations.

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