Left ventricular hypertrophy: prognostic value, pathogenesis, possible remodeling: focusing on angiotensin receptor antagonists
Left ventricular hypertrophy (LVH) is regarded as the main predictor of cardiovascular mortality. "Remodeling" term, preceded by "LVH", includes the whole complex of multi-level changes, from macroscopic to biochemical and genetic, associated with diastolic and systolic myocardial dysfunction, myocardial blood flow and cardiac rhythm disturbances. At the moment, the crucial point in choosing a medication for LVH prevention and treatment is its organo-protective effect, in particular, LVH remodeling facilitation. One of the most promising pharmacological groups includes angiotensin II receptor antagonists (ARA), e. g., irbesartan. This is explained by leading role of renin-angiotensin-aldosterone system in LVH pathogenesis and alternative AT II synthesis path, unaffected by АСE inhibitors. Irbesartan effectiveness in arterial hypertension has been demonstrated in many clinical trials. New data on hypertrophic cardiomyopathy pathogenesis point to possible ARA effectiveness in this disease as well.