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Horm Metab Res 2022; 54(05): 273-279
DOI: 10.1055/a-1793-6134
Review

Cardiac Remodeling in Hypertension: Clinical Impact on Brain, Heart, and Kidney Function

Sophie Mavrogeni
1   Cardiology, National and Kapodistrian University of Athens, Athens, Greece
,
George Piaditis
2   Department of Endocrinology and Diabetes, Errikos Ntynan Hospital Center, Athens, Greece
,
Flora Bacopoulou
3   Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
,
George P. Chrousos
4   First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
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Abstract

Hypertension is the most common causative factor of cardiac remodeling, which, in turn, has been associated with changes in brain and kidney function. Currently, the role of blood biomarkers as indices of cardiac remodeling remains unclear. In contrast, cardiac imaging, including echocardiography and cardiovascular magnetic resonance (CMR), has been a valuable noninvasive tool to assess cardiac remodeling. Cardiac remodeling during the course of systemic hypertension is not the sole effect of the latter. “Remodeling” of other vital organs, such as brain and kidney, also takes place. Therefore, it will be more accurate if we discuss about “hypertensive remodeling” involving the heart, the brain, and the kidneys, rather than isolated cardiac remodeling. This supports the idea of their simultaneous assessment to identify the early, silent lesions of total “hypertensive remodeling”. In this context, magnetic resonance imaging is the ideal modality to provide useful information about these organs in a noninvasive fashion and without radiation. For this purpose, we propose a combined protocol to employ MRI in the simultaneous assessment of the heart, brain and kidneys. This protocol should include all necessary indices for the evaluation of “hypertensive remodeling” in these 3 organs, and could be performed within a reasonable time, not exceeding one hour, so that it remains patient-friendly. Furthermore, a combined protocol may offer “all in one examination” and save time. Finally, the amount of contrast agent used will be limited granted that post-contrast evaluations of the three organs will be performed after 1 injection.

Key words

hypertension - magnetic resonance imaging - heart - brain - kidneys


Publication History

Received: 01 January 2022

Accepted after revision: 03 March 2022

Article published online:
29 March 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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