Resumo

DAVILA-SPINETTI, Diego F et al. Estrategias de tratamiento del paciente con hipertensión arterial esencial: Perfil neurohormonal y geometría ventricular izquierda. Rev. Venez. Endocrinol. Metab. [online]. 2012, vol.10, n.1, pp.5-19. ISSN 1690-3110.

The neurohormonal and hemodynamic profiles, of uncomplicated hypertensive patients, can be inferred from the left ventricular geometric pattern. We have used the left ventricular geometric pattern to guide the pharmacological treatment of hypertensive patients. Blood pressure control can be achieved with less medications and complications and adverse effects are reduced with a therapeutic strategy aimed at the underlying neurohormonal and hemodynamic profiles. On the contrary, cardiac remodelling is unfavorably influenced by a therapeutic strategy unmatched to the underlying responsable mechanisms. During transition to the two phenotypes of congestive heart failure, cardiac remodelling evolves in opposite directions. Thus, patients with systolic heart failure undergo progressive ventricular dilatation with thinning of its walls, where as, diastolic heart failure patients are characterized by shrinking of their left ventricular cavities with increasing relative wall thickness.

Palavras-chave : Ecocardiography; Ventricular geometry; Cardiac remodelling; Sympathetic nervous system; Renin-angiotensin-aldosterone system; Systolic heart failure; Diastolic heart failure.

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