An autopsy study of right ventricular hypertrophy in relation to left ventricular remodelling in arterial hypertension.

Objectives: To study the prevalence and severity of right ventricular hypertrophy (RVH) in relation to left ventricular hypertrophy (LVH) among individuals with hypertension during their lifetime using post-mortem examination records.

Methods: In total, 647 autopsy protocols for individuals with systematic hypertension during their lifetime were investigated at forensic laboratories in Semey (Kazakhstan). Associations between right ventricular wall thickness (RVWT) and left ventricular wall thickness (LVWT) adjusted for age, sex, and ethnic background were studied using multiple quantile regression. LVH and RVH as categorical variables were analysed using chi-square tests and multivariable Poisson regression. Prevalence ratios (PR) were calculated using 95% confidence intervals (CI) with robust standard errors.

Results: The right ventricle hypertrophy during systemic hypertension has been less extensively studied, particularly using post-mortem examination data. The prevalence of LVH and RVH were 100% and 87.2%, respectively. A positive correlation was observed between RVWT and LVWT (r = 0.66, p < 0.001). LVWT was the strongest predictor of RVH (PR = 1.27, 95% CI: 1.19- 1.36). Moreover, male sex (PR = 1.08, 95% CI: 1.01- 1.15) and Russian ethnicity (PR = 1.11, 95% CI: 1.03- 1.20) but not age were associated with RVH in the multivariable model. LVWT was the only significant predictor of RVWT as a continuous dependent variable.

Conclusions: Right ventricular hypertrophy is common in hypertension and is more frequent and pronounced among men and ethnic Russians in Eastern Kazakhstan. Our findings corroborate the existing evidence suggesting that remodelling of the left and right ventricles occurs concurrently.