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Heart Failure Reviews Apr 2002In response to a prolonged pressure- or volume-overload, alterations occur in myocardial fatty acid, glucose, and glycogen metabolism. Oxidation of long chain fatty... (Review)
Review
In response to a prolonged pressure- or volume-overload, alterations occur in myocardial fatty acid, glucose, and glycogen metabolism. Oxidation of long chain fatty acids has been found to be reduced in hypertrophied hearts compared to non-hypertrophied hearts. However, this observation depends upon the degree of cardiac hypertrophy, the severity of carnitine deficiency, the concentration of fatty acid in blood or perfusate, and the myocardial workload. Glycolysis of exogenous glucose is accelerated in hypertrophied hearts. Despite the acceleration of glycolysis, glucose oxidation is not correspondingly increased leading to lower coupling between glycolysis and glucose oxidation and greater H(+) production than in non-hypertrophied hearts. Although glycogen metabolism does not differ in the absence of ischemia, synthesis and degradation of glycogen are accelerated in severely ischemic hypertrophied hearts. These alterations in carbohydrate metabolism may contribute to the increased susceptibility of hypertrophied hearts to injury during ischemia and reperfusion by causing disturbances in ion homeostasis that reduce contractile function and efficiency to a greater extent than normal. As in non-hypertrophied hearts, pharmacologic enhancement of coupling between glycolysis and glucose oxidation (e.g., by directly stimulating glucose oxidation) improves recovery of function of hypertrophied hearts after ischemia. This observation provides strong support for the concept that modulation of energy metabolism in the hypertrophied heart is a useful approach to improve function of the hypertrophied heart during ischemia and reperfusion. Future investigations are necessary to determine if alternative approaches, such as glucose-insulin-potassium infusion and inhibitors of fatty acid oxidation (e.g., ranolazine, trimetazidine), also produce beneficial effects in ischemic and reperfused hypertrophied hearts.
Topics: Cardiomegaly; Energy Metabolism; Glucose; Humans; Myocardial Contraction; Myocardial Ischemia; Severity of Illness Index; Stroke Volume
PubMed: 11988640
DOI: 10.1023/a:1015380609464 -
The American Journal of Cardiology Jun 1988Despite improved patient detection and pharmacologic therapy, the effect of treatment of hypertension on mortality from coronary artery-related events remains... (Review)
Review
Despite improved patient detection and pharmacologic therapy, the effect of treatment of hypertension on mortality from coronary artery-related events remains unresolved. Left ventricular (LV) hypertrophy, a known consequence of hypertension, is associated with an excess mortality independent of other known cardiovascular risk factors. Recently, LV hypertrophy accompanying hypertension has been associated with ominous ventricular arrhythmias. However, it does not necessarily follow that regression of LV hypertrophy will reduce this increased mortality. Diastolic dysfunction, manifested by reduced ventricular distensibility of the hypertrophying left ventricle, appears to be an early characteristic of the hypertensive heart since echocardiographic techniques have demonstrated diastolic filling abnormalities in untreated essential hypertensives even before significant LV hypertrophy appears. Not all antihypertensive agents diminish LV mass and improve diastolic dysfunction. Certain sympatholytic agents, calcium antagonists, beta-adrenergic blockers, and the angiotensin-converting enzyme inhibitors appear to diminish LV hypertrophy. However, future studies are needed to determine if these agents that appear to reverse findings of LV hypertrophy and improve diastolic dysfunction will also reduce risk of coronary artery disease and related events.
Topics: Cardiomegaly; Diastole; Heart Diseases; Humans; Hypertension; United States
PubMed: 2968038
DOI: 10.1016/0002-9149(88)91108-3 -
Journal Francais D'ophtalmologie Mar 2017
Topics: Adult; Female; Humans; Hypertrophy; Retinal Diseases; Retinal Pigment Epithelium
PubMed: 28318711
DOI: 10.1016/j.jfo.2016.11.008 -
Journal of Applied Physiology... Dec 1989The purpose was to study selected structural changes associated with the deficit in maximum specific force (N/cm2) during the early development of skeletal muscle...
The purpose was to study selected structural changes associated with the deficit in maximum specific force (N/cm2) during the early development of skeletal muscle hypertrophy. Ablation of gastrocnemius and plantaris muscles was performed bilaterally in 35-day-old rats (n = 41), and the soleus muscle was studied from days 1 to 30 thereafter. Compared with control muscles from age-matched unoperated rats (n = 48), muscle mass and cross-sectional area increased in parallel from 28 to 52% over the 30-day postoperative period. Specific force of hypertrophied muscle was depressed 38% at days 1 and 3, and by 28% from days 5 to 30 after synergistic muscle ablation compared with age-matched control values. Interstitial space was 38% greater than the control value of 20.4 +/- 1 microliters/100 mg at day 1 only. Protein concentration was depressed 15% for 7 days after the ablation operation, and connective tissue protein concentration was unchanged. The relative magnitude of increased mean fiber cross-sectional area was less than that of muscle mass until day 7 after ablation. Mononuclear cell infiltration in interfascicular spaces occurred from days 3 to 30 without light microscopic evidence of muscle fiber injury. Initial functional deficits are explained in part by an enlarged interstitial space and decreased protein concentration; later deficits are likely accounted for by intracellular changes.
Topics: Animals; Female; Hypertrophy; Muscle Contraction; Muscles; Rats; Rats, Inbred Strains
PubMed: 2606868
DOI: 10.1152/jappl.1989.67.6.2600 -
West African Journal of Medicine 2007Breast hypertrophy presents at puberty or thereafter. It is a condition of abnormal enlargement of the breast tissue in excess of the normal proportion. Gland...
BACKGROUND
Breast hypertrophy presents at puberty or thereafter. It is a condition of abnormal enlargement of the breast tissue in excess of the normal proportion. Gland hypertrophy, excessive fatty tissue or a combination of both may cause this condition. Macromastia can be unilateral or bilateral.
OBJECTIVE
To present a case of massive bilateral gigantomastia with huge bilateral hypertrophy of the axillary breasts.
METHODS
Review of the prentation, clinical and investigative findings aswell as the outcome of surgical intervention of a young Nigerian woman with bilateral severe breast hypertrophy and severe hypertrophy of axillary breasts.
RESULT
The patient was a 26-year-old woman who presented with massive swelling of her breasts and bilateral axillary swellings, both of six years duration.. In addition to the breast pathology, she also suffered significant psychological problems. The breast ultrasonography confirmed only diffuse swellings, with no visible lumps or areas of calcifiCation. She had total bilateral excision of the hypertrophied axillary breasts, and bilateral breast amputation with composite nipple-areola complex graft of the normally located breasts.The total weight of the breast tissues removed was 44.8 kilogram.
CONCLUSION
Macromastia of this size is very rare. This case to date is probably the largest in the world literature. Surgical treatment of the condition gives a satisfactory outcome.
Topics: Adult; Breast; Breast Diseases; Female; Humans; Hypertrophy
PubMed: 18399346
DOI: No ID Found -
Journal of Plastic, Reconstructive &... 2008Gigantomastia is a rare, psychologically and physically disabling condition characterised by excessive breast growth. To date, there is no universal classification or... (Review)
Review
INTRODUCTION
Gigantomastia is a rare, psychologically and physically disabling condition characterised by excessive breast growth. To date, there is no universal classification or accepted definition for this condition. Many authors cite gigantomastia as breast enlargement that requires reduction of over 1500 g per breast. However, there is discordance in the literature with the weight of reduction ranging from 0.8 to 2 kg, or even a D cup bra size. Practically this is a postoperative definition which is of little use to the clinician in terms of patient management or prognosis.
METHOD
We conducted a literature review and meta analysis of all published cases of gigantomastia. We combined this with seven cases managed at Selly Oak Hospital, Birmingham, to give us a series of 115 patients. In order to devise a universally accepted definition of gigantomastia, a survey of 150 plastic surgery consultants within Europe was conducted. Participants were e-mailed a questionnaire, requesting their definition of gigantomastia with an appropriate excision weight. They were also asked to comment on any preoperative measurements taken to establish this predicted weight.
CONCLUSION
We propose a classification of gigantomastia based on the cause, management and prognosis of the disease.
Topics: Adolescent; Adult; Breast; Child; Female; Humans; Hypertrophy; Mammaplasty; Mastectomy; Middle Aged; Organ Size; Pregnancy; Pregnancy Complications; Treatment Outcome
PubMed: 18054304
DOI: 10.1016/j.bjps.2007.10.041 -
The American Journal of Pathology Dec 2017Ligamentum flavum (LF) hypertrophy causes lumbar spinal canal stenosis, leading to leg pain and disability in activities of daily living in elderly individuals. Although...
Ligamentum flavum (LF) hypertrophy causes lumbar spinal canal stenosis, leading to leg pain and disability in activities of daily living in elderly individuals. Although previous studies have been performed on LF hypertrophy, its pathomechanisms have not been fully elucidated. In this study, we demonstrated that infiltrating macrophages were a causative factor for LF hypertrophy. Induction of macrophages into the mouse LF by applying a microinjury resulted in LF hypertrophy along with collagen accumulation and fibroblasts proliferation at the injured site, which were very similar to the characteristics observed in the severely hypertrophied LF of human. However, we found that macrophage depletion by injecting clodronate-containing liposomes counteracted LF hypertrophy even with microinjury. For identification of fibroblasts in the LF, we used collagen type I α linked to green fluorescent protein transgenic mice and selectively isolated green fluorescent protein-positive fibroblasts from the microinjured LF using laser microdissection. A quantitative RT-PCR on laser microdissection samples revealed that the gene expression of collagen markedly increased in the fibroblasts at the injured site with infiltrating macrophages compared with the uninjured location. These results suggested that macrophage infiltration was crucial for LF hypertrophy by stimulating collagen production in fibroblasts, providing better understanding of the pathophysiology of LF hypertrophy.
Topics: Aged; Aged, 80 and over; Animals; Collagen; Female; Fibroblasts; Humans; Hypertrophy; Ligamentum Flavum; Lumbosacral Region; Macrophages; Male; Mice; Mice, Inbred C57BL; Mice, Transgenic; Spinal Stenosis
PubMed: 28935572
DOI: 10.1016/j.ajpath.2017.08.020 -
The Journal of Clinical Investigation May 1981Measurements of right coronary artery blood flow, aortic and right ventricular (RV) pressures and heart rate were radiotelemetered during strenuous, spontaneous exercise...
Measurements of right coronary artery blood flow, aortic and right ventricular (RV) pressures and heart rate were radiotelemetered during strenuous, spontaneous exercise in normal dogs and dogs with severe RV hypertrophy induced by chronic (5-6 mo) pulmonary artery stenosis. With fixed pulmonic stenosis, dogs with RV hypertrophy exhibited a decrease (P less than 0.01) in arterial pressure during exercise. Under these conditions, exercise increased right coronary artery blood flow and decreased right coronary vascular resistance less (P less than 0.05) in dogs with RV hypertrophy compared with normal. This attenuated response of right coronary artery blood flow of dogs with RV hypertrophy was not observed when arterial pressures remained at preexercise values during exercise. However, regardless of changes in arterial pressures during exercise, all dogs with RV hypertrophy demonstrated a striking postexercise coronary hyperemia (P less than 0.01), suggesting a perfusion deficit of the hypertrophied right ventricle during exercise. These results imply a fundamental defect in the ability of the coronary circulation of the severely hypertrophied right ventricle to provide sufficient nutrient supply in the face of elevated metabolic demands of exercise.
Topics: Animals; Cardiomegaly; Coronary Circulation; Dogs; Female; Heart Rate; Hemodynamics; Male; Physical Exertion; Stress, Physiological
PubMed: 6453133
DOI: 10.1172/jci110160 -
Arthroscopy : the Journal of... Jun 2008The purpose of this study was to examine the clinical features and diagnosis of patients with mucoid hypertrophy of the anterior cruciate ligament (ACL) and to assess...
PURPOSE
The purpose of this study was to examine the clinical features and diagnosis of patients with mucoid hypertrophy of the anterior cruciate ligament (ACL) and to assess the results of arthroscopic treatment.
METHODS
Between May 1999 and August 2005, 156 knees in 132 patients were diagnosed with mucoid hypertrophy of the ACL and underwent arthroscopic treatment. Of these, 106 knees in 91 patients (86 women and 5 men), with a mean age of 61 years (range, 42 to 80 years), were followed up for at least 2 years. All 106 knees had central knee pain on terminal extension without preceding trauma, and 83 (78.3%) had extension deficit. Magnetic resonance imaging showed thickened, ill-defined ACLs with increased intraligamentous signals. Arthroscopy showed osteoarthritic changes of varying degrees in all, with 84 (79.2%) having intercondylar notch narrowing and 102 (96.2%) having additional degenerative pathologies. The posterolateral portion of the ACL appeared hypertrophied, which impinged on the lateral wall and roof of the notch. Arthroscopic debridement of hypertrophied ACLs was performed with or without notchplasty, according to the severity of impingement.
RESULTS
Good to excellent pain relief on terminal extension was obtained in 92 of 106 knees (86.8%), including complete pain relief in 57 (53.8%). The extension deficit was normalized in 68 of 83 affected knees (81.9%). Lachman and anterior drawer tests showed a firm endpoint in all, and 85.8% showed good to excellent subjective satisfaction.
CONCLUSIONS
Mucoid hypertrophy of the ACL should be suspected in elderly women presenting pain on terminal extension without preceding trauma, especially when associated with extension deficit. The magnetic resonance imaging findings are specific for preoperative diagnoses. Partial ACL debridement with notchplasty provides safe and effective symptom relief. Extension pain improved significantly in 92 of 106 knees (86.8%), and extension deficit was normalized in 68 of 83 knees (81.9%).
Topics: Adult; Aged; Aged, 80 and over; Anterior Cruciate Ligament; Arthroscopy; Debridement; Female; Follow-Up Studies; Humans; Hypertrophy; Magnetic Resonance Imaging; Male; Middle Aged; Osteoarthritis, Knee; Pain; Postoperative Care
PubMed: 18514107
DOI: 10.1016/j.arthro.2008.02.004 -
Trends in Cardiovascular Medicine Nov 2011In response to injury, the myocardium hypertrophies in an attempt to maintain or augment function, which is associated with ventricular remodeling and changes in... (Review)
Review
In response to injury, the myocardium hypertrophies in an attempt to maintain or augment function, which is associated with ventricular remodeling and changes in capillary density. During the compensatory phase of the hypertrophic response, the myocardium maintains output and is characterized by a coordinated neo-angiogenic and fibrotic response that supports cardiomyocyte health and survival. Emerging evidence shows that paracrine-mediated cross talk between cardiac myocytes and nonmyocytes within the heart is critical for cardiac adaptation to stress, including the extent of hypertrophy and angiogenesis. This review discusses recent results indicating that placental growth factor (PGF; also called PlGF), a secreted factor within the vascular endothelial growth factor superfamily, is a pivotal mediator of adaptive cardiac hypertrophy and beneficial angiogenesis through its ability to coordinate the intercellular communication between different cell types in the heart.
Topics: Adaptation, Physiological; Animals; Cardiomegaly; Humans; Myocardium; Neovascularization, Physiologic; Paracrine Communication; Placenta Growth Factor; Pregnancy Proteins; Signal Transduction; Ventricular Remodeling
PubMed: 22902069
DOI: 10.1016/j.tcm.2012.05.014