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Hypertension is the most common causative factor of cardiac remodeling, which, inturn, 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 cardiovascularmagnetic resonance (CMR), has been a valuable noninvasive tool to assess cardiacremodeling. Cardiac remodeling during the course of systemic hypertension is notthe sole effect of the latter. “Remodeling” of other vitalorgans, such as brain and kidney, also takes place. Therefore, it will be moreaccurate if we discuss about “hypertensive remodeling” involvingthe 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 thiscontext, magnetic resonance imaging is the ideal modality to provide usefulinformation about these organs in a noninvasive fashion and without radiation.For this purpose, we propose a combined protocol to employ MRI in thesimultaneous assessment of the heart, brain and kidneys. This protocol shouldinclude all necessary indices for the evaluation of “hypertensiveremodeling” in these 3 organs, and could be performed within areasonable time, not exceeding one hour, so that it remains patient-friendly.Furthermore, a combined protocol may offer “all in oneexamination” and save time. Finally, the amount of contrast agent usedwill be limited granted that post-contrast evaluations of the three organs willbe performed after 1 injection.

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