By Enrico Agabiti Rosei, Giuseppe Mancia
This booklet offers updated info on the way to determine early preclinical adjustments within the center, the small and massive arteries and the kidney utilizing the main delicate, particular and comparatively cheap innovations. a large choice of thoughts are mentioned, with cautious realization to the newest advancements. for every organ, facts is documented in regards to the occurrence of organ harm within the basic and the hypertensive inhabitants. details is equipped at the strength induction of regression of organ harm by means of therapy, the standards for developing major adjustments and the medical prognostic value of regression. The guide can be worthy for all practitioners answerable for the scientific administration of hypertensive sufferers, provided that the evaluation of early preclinical cardiovascular and renal harm allows extra actual possibility stratification at baseline and enables evaluate of cardiovascular safety whilst regression of structural alterations is accomplished in the course of treatment.
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Additional info for Assessment of Preclinical Organ Damage in Hypertension
In this regard, CT coronary angiography has an excellent negative predictive value, while positive predictive value is low, and therefore an exam with normal findings can practically rule out coronary artery disease . Cardiac CT is additionally used for coronary plaque imaging. The straight relation between coronary arteries’ amount of calcium and atherosclerotic plaque burden has already been established [31, 33]. Coronary artery calcium (CAC) can be observed with electron beam computed tomography (EBCT) as well as with MDCT, and for its quantification, among the different methods suggested, ‘Agatston score’ is the most common .
Another application of cardiac CT is in the assessment of cardiac morphology and function; nevertheless, it is improbable to become the method of choice for this purpose. This is mostly due to the radiation exposure and the contrast material used . As a matter of fact, myocardial mass, left and right endsystolic and end-diastolic volumes, ejection fraction and stroke volume can be calculated in this way with great accuracy [30, 31]. As far as calculation of left ventricular function is concerned, different studies have indicated the good correlation between CT and MRI as well as between CT and echocardiography in this field [31, 35–37].
Inappropriate left ventricular mass: reliability and limitations of echocardiographic measurement for risk stratification and follow-up in single patients. J Hypertens. 2006;24(11):2293–8. 21. Kusunose K, Kwon DH, Motoki H, Flamm SD, Marwick TH. Comparison of three-dimensional echocardiographic findings to those of magnetic resonance imaging for determination of left ventricular mass in patients with ischemic and non-ischemic cardiomyopathy. Am J Cardiol. 2013;112(4):604–11. 22. Schillaci G, Verdecchia P, Porcellati C, Cuccurullo O, Cosco C, Perticone F.