scholarly journals Marked Regression of Left Ventricular Hypertrophy after Outflow Desobliteration in HOCM

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Zisis Dimitriadis ◽  
Frank van Buuren ◽  
Nikola Bogunovic ◽  
Dieter Horstkotte ◽  
Lothar Faber
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
Threshold Value ◽  
Left Ventricular ◽  
Risk Markers ◽  
Icd Implantation ◽  
Maximum Wall Thickness ◽  
Percutaneous Septal Ablation

We present an HOCM patient in whom marked regression of left ventricular hypertrophy occurred within two years following outflow desobliteration by percutaneous septal ablation. Maximum wall thickness (initially documented by both echo and MRI) decreased from 34 mm to 22 mm (followup by echo only due to presence of the ICD), crossing the threshold value of 30 mm which was one of the risk markers that had triggered the primary prophylactic ICD implantation in this case prior to septal ablation.

P1772Diagnostic accuracy of a novel electrocardiographic criterion for the diagnosis of left ventricular hypertrophy in hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P M Azevedo ◽  
C Guerreiro ◽  
R Ladeiras-Lopes ◽  
R Faria ◽  
N Ferreira ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
High Specificity ◽  
Left Ventricular ◽  
S Wave ◽  
Diagnostic Modality ◽  
Maximum Wall Thickness ◽  
Higher Sensitivity

Abstract Introduction The 12-lead electrocardiogram (ECG) is a fundamental initial diagnostic modality for the early evaluation of a patient suspected of having hypertrophic cardiomyopathy (HCM). ECG criteria for the diagnosis of left ventricular hypertrophy (LVH) typically have low sensitivity and high specificity. Recently, a novel ECG criterion (Peguero-Lo Presti, PLP) with higher sensitivity (62%) and similar specificity (90%) was developed in a cohort of hypertensive patients, but its accuracy in patients with HCM has not been tested. We hypothesized that Peguero-Lo Presti criterion would improve upon the sensitivity of other criteria, while maintaining high specificity, for the diagnosis of LVH in patients for with HCM. Methods We retrospectively analyzed 215 consecutive patients who underwent cardiac magnetic resonance (CMR) between 2010 and 2018 for suspected HCM. All patients aged 18 years or older, who had CMR-confirmed HCM and an ECG without confounders (complete left or right bundle brunch block or paced ventricular rhythm) were included for analysis (n=88). Left ventricular mass (LVM) index and maximum wall thickness were derived from CMR analysis. The PLP criteria was defined as the sum of the deepest S wave (SD) in any lead and the S wave amplitude of lead V4 (SV4). Cornell voltage (CL) and Sokolow-Lyon (SL) were used for comparison. We randomly selected 88 gender-matched patients who performed an ECG and CMR for other clinical reasons and who had no structural heart disease or LVH for use as controls. The DeLong and McNemar's test were used to compare ROC area under the curve (AUC) and sensitivity and specificity, respectively, between the three criteria. Results 88 patients with HCM (63% male, mean age 56.7±15 years) were analyzed. The mean maximum wall thickness was 19.9±4.4mm and mean indexed LVM was 89.7±27g/m2. 34 patients (38.6%) had increased indexed LVM and 77 (87.5%) had at least one segment with late gadolinium enhancement (LGE). Discrimination by AUC was highest for PLP (0.85 [95% CI 0.8–0.9]), compared to CL (0.79, p=0.03) and SL (0.73, p=0.02). Using literature cut-offs, the sensitivity of PLP (60% [95% CI 50–70%]) was significantly higher compared to CL (40% [95% CI 30–50%, p<0,001) and SL (41%, [95% CI 31–51%], p=0.01), whilst maintaining high specificity (PLP 96%; CL 98%; SL 94%). After adjusting for LVM, the amount of LGE had a positive correlation with PLP amplitude (Spearman's rho=0.6, coef=2.4, p=0.01), but not Cornell or Sokolow. The sensitivity of PLP was significantly higher than CL and Sokolow in patients with LGE (61% vs 44% vs 43%, p<0.05). Conclusion The Peguero-Lo Presti criteria demonstrated higher sensitivity and similar specificity when compared to the Cornell and Sokolow-Lyon criteria for the diagnosis of LVH in a cohort of patients with hypertrophic cardiomyopathy. Therefore, they could become the standard ECG diagnostic criteria in patients suspected of having LVH and HCM.

Blood Pressure Control and Left Ventricular Hypertrophy in Long-Term Capd and Hemodialysis Patients: A Cross-Sectional Study

2003 ◽  
Vol 23 (6) ◽  
pp. 563-567 ◽  
Author(s):  
Ali Ihsan Günal ◽  
Erdogan Ilkay ◽  
Ercan Kirciman ◽  
Ilgin Karaca ◽  
Ayhan Dogukan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Volume Control ◽  
Left Ventricular Chamber ◽  
Significant Difference

Background It is still not clear whether hypertension and left ventricular hypertrophy (LVH) are more common in continuous ambulatory peritoneal dialysis (CAPD) than in hemodialysis (HD) patients. Methods To examine this subject, the indices of cardiac performance were compared between 50 HD and 34 CAPD patients. Patients were further divided into two subgroups [long-term (L) CAPD and L-HD] according to dialysis modality and duration of dialysis (more than 60 months’ duration). Results The blood pressure and cardiothoracic index of CAPD patients did not differ from HD patients. On average, the left atrial index was 2 mm/m2 higher in HD patients than in CAPD patients. Left ventricular chamber sizes, wall thickness, and left ventricular mass index (LVMI) in patients on CAPD were similar to those of HD patients. Isovolumic relaxation time (IVRT) of CAPD patients was insignificantly less than that of HD patients (101 ± 22 and 115 ± 27 msec respectively). There was no significant difference between the two subgroups (L-HD and L-CAPD) in blood pressure, left atrial diameter, left ventricular chamber size, wall thickness, LVMI, ejection fraction, or IVRT. Conclusion If normovolemia and normotension are obtained by strict volume control without using antihypertensive drugs, the effects of the two modalities of chronic dialysis treatment (HD and CAPD) on cardiac structure and function are not different from each other.

scholarly journals P962 The Remodeling Index risk stratifies patients with hypertensive left ventricular hypertrophy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T T Le ◽  
J Bryant ◽  
B Ang ◽  
B Su ◽  
S Cook ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Prognostic Value ◽  
Ventricular Hypertrophy ◽  
Fold Increase ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Single Measure ◽  
Hypertensive Patients ◽  
Remodeling Index

Abstract Funding Acknowledgements National Medical Research Council BACKGROUND Hypertensive left ventricular hypertrophy (LVH) is associated with increased cardiovascular events. The authors previously developed the Remodeling Index (RI) that incorporated LV volume and wall-thickness in a single measure of advanced hypertrophy in hypertensive patients. PURPOSE This study examined the mechanisms and prognostic potential of the RI in reference with current LVH classifications. METHODS Cardiovascular magnetic resonance (CMR) was performed in 400 asymptomatic hypertensive patients. The newly derived RI ([(EDV)^1/3]/t; where EDV is LV end-diastolic volume and t is the maximal wall thickness across 16 myocardial segments) stratified hypertensive patients into 3 groups: without LVH, LVH with normal RI (LVH_Normal-RI) and LVH with low RI (LVH_Low-RI). The primary outcome was a composite of all-cause mortality, acute coronary syndromes, strokes and decompensated heart failure. RESULTS LVH_Low-RI was associated with increased LV mass index, fibrosis burden, impaired myocardial function and elevated biochemical markers of myocardial injury and wall stress. Over 18.3 ± 7.0 months (601.3 patient-years), patients with LVH_Low-RI had more than a 5-fold increase in adverse events compared to those with LVH_Normal-RI (11.6 events/100patient-years versus 2.0 events/100 patient-years, respectively; log-rank P &lt; 0.001; Figure A). The RI provided incremental prognostic value over and above a model consisting of clinical variables and LVH (P = 0.02). Conversely concentric and eccentric LVH were associated with adverse prognosis (4.5 events/100patient-years versus 6.0 events/100patient-years, respectively; log-rank P = 0.62) that was similar as the natural history of hypertensive LVH (5.1 events/100patient-years). CONCLUSIONS The RI provides mechanistic insights and prognostic value that improves risk-stratification of hypertensive LVH. Abstract P962 Figure.

Measurement of Wall Thickness Alone Does Not Accurately Assess the Presence of Left Ventricular Hypertrophy

2007 ◽  
Vol 29 (2) ◽  
pp. 119-125 ◽  
Author(s):  
David Leibowitz ◽  
David Planer ◽  
Fanny Ben-Ibgi ◽  
David Rott ◽  
A. Teddy Weiss ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
Left Ventricular

scholarly journals 585 Natural history of left ventricular hypertrophy in infants of diabetic mothers

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Emanuele Monda ◽  
Federica Verrillo ◽  
Michele Lioncino ◽  
Ippolita Altobelli ◽  
Martina Caiazza ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
P Value ◽  
Z Score ◽  
Benign Condition ◽  
Infants Of Diabetic Mothers ◽  
Diabetic Mothers

Abstract Aims This study sought to describe the characteristics and the natural course of left ventricular hypertrophy (LVH) in a well-characterized consecutive cohort of infants of diabetic mothers (IDMs). Methods and results Sixty consecutive IDMs with LVH have been retrospectively identified and enrolled in the study. All IDMs were evaluated at baseline and every 6 months until LV wall thickness regression, defined as the decrease of wall thickness measurement into the normal reference range for cardiac parameters (z-score &gt; −2 and &lt;2). A comprehensive assessment was performed in those patients with diagnostic markers suggestive of a different cause and/or without significant reduction of the LVH during follow-up. At 1-year follow-up, all IDMs showed a significant reduction of maximal wall thickness MWT [6.00 mm (IQR: 5.00–712) vs. 5.50 mm (IQR: 5.00–6.00), P-value &lt;0.001; MWT-z-score: 4.86 (IQR: 3.93–7.61) vs. 1.72 (IQR: 1.08–2.85), P-value &lt;0.001] compared to baseline, and all patients showed LV wall thickness regression or residual mild or moderate LVH (57%, 28%, and 12%, respectively), except two patients with persistent severe LVH, that after a comprehensive clinical-genetic assessment were diagnosed as Noonan syndrome with multiple lentigines. At multivariate analysis, MWT was negatively associated with LV wall thickness regression at 1-year follow-up [MWT-mm: OR: 0.48 (0.29–0.79), P-value = 0.004; MWT-z-score: OR: 0.71 (0.56–0.90), P-value = 0.004]. Conclusions LVH in IDMs represents a benign condition with complete regression during the first years of life. In those patients without LV wall thickness regression, combined with clinical markers suggesting a specific disease, a complete work-up is required for a definite diagnosis.

Left Ventricular Hypertrophy and Clinical Outcome in CAPD Patients

2000 ◽  
Vol 20 (4) ◽  
pp. 461-466 ◽  
Author(s):  
Songkwan Silaruks ◽  
Dhavee Sirivongs ◽  
Darunee Chunlertrith
Keyword(s):  
Peritoneal Dialysis ◽  
Left Ventricular Hypertrophy ◽  
Clinical Outcome ◽  
Dilated Cardiomyopathy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Dialysis Unit ◽  
Cumulative Survival ◽  
Cardiovascular Morbidity And Mortality

Objective To determine the clinical outcome of left ventricular hypertrophy (LVH) (left ventricular wall diastole thickness ≥ 1.2 cm) detected by echocardiography in non-diabetic, continuous ambulatory peritoneal dialysis (CAPD) patients without dilated cardiomyopathy. Design A prospective, descriptive study was conducted between 1 July 1995 and 31 January 1998. Patients were followed up for 24 months. Setting Peritoneal dialysis unit in a medical school hospital. Patients and Methods Baseline and yearly echocardiograms were carried out on 66 patients receiving CAPD. Cardiac death was assessed. LVH was correlated with outcome. Results Of 66 nondiabetic CAPD patients without dilated cardiomyopathy, 20 had a normal echocardiogram (LV wall thickness < 1.2 cm), 21 had mild hypertrophy, and 25 severe hypertrophy (LV wall thickness > 1.4 cm in diastole). In the first two groups, 21% were admitted with congestive heart failure (CHF) after starting dialysis. The 1-year cumulative survival was 85% among those with mild hypertrophy and 91% in the normal group. In the group with severe hypertrophy, 57% were admitted at least once with CHF, and the 1-year cumulative survival was 56%. Eighty-two percent of those who died in the severe group, which accounted for the significantly worse survival ( p = 0.003), died from cardiac or cerebrovascular causes, compared with none of those with a normal echocardiogram. Conclusions Severe LVH was found in a third of our CAPD patients and was associated with a significantly high cardiovascular morbidity and mortality.

scholarly journals Pseudohypertrophy of the left ventricle secondary to anaphylaxis: A case report

2019 ◽  
Vol 47 (3) ◽  
pp. 295-299
Author(s):  
Christopher AHG Wong ◽  
Sivasundari Arumugam
Keyword(s):  
Left Ventricle ◽  
Left Ventricular Hypertrophy ◽  
Wall Thickness ◽  
Ventricular Hypertrophy ◽  
Point Of Care ◽  
Young Female ◽  
Left Ventricular ◽  
General Anaesthetic ◽  
Transthoracic Echocardiogram ◽  
Echocardiographic Finding

We report a case of pseudohypertrophy of the left ventricle secondary to hypovolaemia from anaphylaxis. The patient was a healthy young female who developed anaphylaxis during a general anaesthetic. A transthoracic echocardiogram performed during the anaphylaxis crisis demonstrated significant left ventricular hypertrophy. However, when the anaphylaxis had resolved, a follow-up transthoracic echocardiogram demonstrated a normal left ventricular wall thickness. This left ventricular hypertrophy was a pseudohypertrophy as the left ventricular mass was normal and the wall thickness normalised when the hypovolaemia and anaphylaxis had resolved. Pseudohypertrophy of the left ventricle is an echocardiographic finding that suggests hypovolaemia. Furthermore, this echocardiographic finding supports the importance of volume resuscitation in the management of anaphylaxis. This phenomenon may be more frequently reported in the future due to the wider availability of point-of-care ultrasonography along with an increase in the number of physicians trained in echocardiography.

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