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Progress in Cardiovascular Diseases 2012Early investigations in the late 1890s and early 1900s documented cardiac enlargement in athletes with above-normal exercise capacity and no evidence of cardiovascular... (Review)
Review
Early investigations in the late 1890s and early 1900s documented cardiac enlargement in athletes with above-normal exercise capacity and no evidence of cardiovascular disease. Such findings have been reported for more than a century and continue to intrigue scientists and clinicians. It is well recognized that repetitive participation in vigorous physical exercise results in significant changes in myocardial structure and function. This process, termed exercise-induced cardiac remodeling (EICR), is characterized by structural cardiac changes including left ventricular hypertrophy with sport-specific geometry (eccentric vs concentric). Associated alterations in both systolic and diastolic functions are emerging as recognized components of EICR. The increasing popularity of recreational exercise and competitive athletics has led to a growing number of individuals exhibiting these findings in routine clinical practice. This review will provide an overview of EICR in athletes.
Topics: Adaptation, Physiological; Athletes; Exercise; Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Physical Endurance; Ventricular Function, Left; Ventricular Remodeling
PubMed: 22386288
DOI: 10.1016/j.pcad.2012.01.006 -
Echocardiography (Mount Kisco, N.Y.) Mar 2018The clinical significance of papillary muscle hypertrophy and its electrocardiography (ECG) findings has not been fully elucidated. This study aimed to investigate the... (Comparative Study)
Comparative Study
AIMS
The clinical significance of papillary muscle hypertrophy and its electrocardiography (ECG) findings has not been fully elucidated. This study aimed to investigate the relationship between ECG findings and papillary muscle hypertrophy and to confirm the importance of papillary muscle measurements on transthoracic echocardiography (TTE).
METHODS AND RESULTS
Of the 237 consecutive patients who showed left ventricular hypertrophy (LVH) pattern on a 12-lead ECG, TTE data were available for 101 patients. The patients were divided into the two groups according to the presence (ECG-LVH [strain pos] group, n = 60) or absence (ECG-LVH [strain neg] group, n = 41) of LV strain pattern (study 1). The prevalence of papillary muscle hypertrophy using TTE was significantly higher in the ECG-LVH (strain neg) group than in the ECG-LVH (strain pos) group (P = .0002). Of the 42 cases with papillary muscle hypertrophy, 5 cases (12%) showed isolated papillary muscle hypertrophy with normal geometry. ECG data were prospectively analyzed for 36 patients who were diagnosed with papillary muscle hypertrophy by TTE (study 2). The prevalence of LV strain pattern was significantly higher in patients with LV wall hypertrophy than in those without LV wall hypertrophy (P = .04). Of the 25 cases with papillary muscle hypertrophy, 6 cases (24%) showed normal geometry and 4 cases (16%) showed ECG abnormality.
CONCLUSIONS
Isolated papillary muscle hypertrophy can cause ECG abnormalities such as LV high voltage and LV strain pattern. Particular attention must be paid to the papillary muscle during echocardiographic examinations.
Topics: Aged; Echocardiography; Electrocardiography; Female; Heart Ventricles; Humans; Hypertrophy; Hypertrophy, Left Ventricular; Male; Papillary Muscles; Reproducibility of Results
PubMed: 29280520
DOI: 10.1111/echo.13789 -
Journal of Investigative Surgery : the... 1988Previous models of right ventricular hypertrophy (RVH) created by pulmonary artery (PA) banding in adult large animals have been associated with an unpredictable...
Previous models of right ventricular hypertrophy (RVH) created by pulmonary artery (PA) banding in adult large animals have been associated with an unpredictable response of the right ventricle to the band and a high mortality due to the variable degree of acute stenosis. We studied the efficacy of PA banding in young pigs to produce RVH by progressive gradual stenosis during growth. Sixteen Yorkshire pigs at 6 weeks of age had nonconstricting 5-mm wide Dacron strips placed around the PA via a left minithoracotomy. The animals were returned for study in 2-3 months. There were no deaths during the growth period. Five sham-operated pigs acted as controls. Right ventricular free wall (RVFW) to total heart weight ratio was greater in the banded group (0.38 +/- 0.05 vs. 0.28 +/- 0.01, P less than .005) as was the RVFW to left ventricular free wall (LVFW) weight (1.09 +/- 0.25 versus 0.66 +/- 0.03, P less than .005). While the LVFW to total heart weight ratio decreased (0.36 +/- 0.04 vs 0.45 +/- 0.05, P less than .005), the septal ratio did not change (0.26 +/- 0.04 vs. 0.29 +/- 0.02, NS), indicating concomitant septal hypertrophy. This technique is simple, reliable, and reproducible in creating right ventricular and septal hypertrophy in the young pig with no mortality during maturation.
Topics: Animals; Cardiomegaly; Constriction; Disease Models, Animal; Heart Ventricles; Organ Size; Pulmonary Artery; Swine
PubMed: 2978984
DOI: 10.3109/08941938809141075 -
Heart (British Cardiac Society) May 2019
Topics: Adult; Heart Defects, Congenital; Heart Ventricles; Humans; Hypertrophy, Right Ventricular; Magnetic Resonance Imaging, Cine; Male; Severity of Illness Index; Ventricular Function, Right; Ventricular Outflow Obstruction; Ventricular Remodeling
PubMed: 30661039
DOI: 10.1136/heartjnl-2018-314123 -
Journal of Human Hypertension Jan 2015Left ventricular (LV) hypertrophy and remodeling are frequently seen in hypertensive subjects and result from a complex interaction of several hemodynamic and... (Review)
Review
Left ventricular (LV) hypertrophy and remodeling are frequently seen in hypertensive subjects and result from a complex interaction of several hemodynamic and non-hemodynamic variables. Although increased blood pressure is considered the major determinant of LV structural alterations, ethnicity, gender, environmental factors, such as salt intake, obesity and diabetes mellitus, as well as neurohumoral and genetic factors might influence LV mass and geometry. The conventional concept of hypertensive LV remodeling has been that hypertension leads to concentric hypertrophy, as an adaptive response to normalize wall stress, which is then followed by chamber dilation and heart failure. However, several lines of evidence have challenged this dogma. Concentric hypertrophy is not the most frequent geometric pattern and is less usually seen than eccentric hypertrophy in hypertensive subjects. In addition, data from recent studies suggested that transition from LV concentric hypertrophy to dilation and systolic dysfunction is not a common finding, especially in the absence of coronary heart disease. LV hypertrophy is also consistently associated with increased cardiovascular morbidity and mortality, raising doubts whether this phenotype is an adaptive response. Experimental evidence exists that a blunting of load-induced cardiomyocyte hypertrophy does not necessarily result in LV dysfunction or failure. Furthermore, the hypertrophic myocardium shows fibrosis, alterations in the coronary circulation and cardiomyocyte apoptosis, which may result in heart failure, myocardial ischemia and arrhythmias. Overall, this body of evidence suggests that LV hypertrophy is a complex phenotype that predicts adverse cardiovascular outcomes and may not be necessarily considered as an adaptive response to systemic hypertension.
Topics: Animals; Blood Pressure; Fibrosis; Heart Ventricles; Humans; Hypertension; Hypertrophy, Left Ventricular; Prognosis; Risk Assessment; Risk Factors; Ventricular Function, Left; Ventricular Remodeling
PubMed: 24804791
DOI: 10.1038/jhh.2014.36 -
Heart (British Cardiac Society) Jun 2001
Review
Topics: Diagnosis, Differential; Echocardiography; Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Physical Education and Training
PubMed: 11359735
DOI: 10.1136/heart.85.6.615 -
Progress in Cardiovascular Diseases 2014Abnormal left ventricular (LV) geometry, including LV hypertrophy (LVH), is associated with increased risk of major cardiovascular (CV) events and all-cause mortality... (Review)
Review
Abnormal left ventricular (LV) geometry, including LV hypertrophy (LVH), is associated with increased risk of major cardiovascular (CV) events and all-cause mortality and may be an independent predictor of morbid CV events. Patients with LVH have increased risk of congestive heart failure, coronary heart disease, sudden cardiac death and stroke. We review the risk factors for LVH and its consequences, as well as the risk imposed by concentric remodeling (CR). We also examine evidence supporting the benefits of LVH regression, as well as evidence regarding the risk of CR progressing to LVH, as opposed to normalization of CR. We also briefly review the association of abnormal LV geometry with left atrial enlargement and the combined effects of these structural cardiac abnormalities.
Topics: Echocardiography; Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Prognosis; Ventricular Remodeling
PubMed: 25081397
DOI: 10.1016/j.pcad.2014.05.003 -
JPMA. the Journal of the Pakistan... Oct 2018: To determine the efficacy of high-dose allopurinol in reducing left ventricular mass in patients with left ventricular hypertrophy by comparing its efficacy with... (Randomized Controlled Trial)
Randomized Controlled Trial
Efficacy of high dose Allopurinol in reducing left ventricular mass in patients with left ventricular hypertrophy by comparing its efficacy with Febuxostat - a randomized controlled trial.
OBJECTIVE
: To determine the efficacy of high-dose allopurinol in reducing left ventricular mass in patients with left ventricular hypertrophy by comparing its efficacy with febuxostat..
METHODS
The randomised controlled interventional study was conducted at Mayo Hospital, Lahore, Pakistan, from April to December 2015, comprising patients with left ventricular hypertrophy on echocardiography. They were randomly divided into two equal groups, with Group A receiving allopurinol and Group B receiving febuxostat. Primary endpoint was reduction in left ventricular mass and left ventricular mass index as calculated by echocardiography. Patients were followed at third and sixth month of enrolment to detect regression. Patients were investigated for eosinophil's count, urine for micro albuminuria and renal function tests to monitor side effects of allopurinol. SPSS 20 was used for data analysis.
RESULTS
There were 76 patients divided into two groups of 38(50%) each. Mean reduction in left ventricular mass between baseline and at six months in Group A and Group B was 35.474±13.54 and 21.921±3.33 respectively (p=0.0001) while mean reduction in left ventricular mass index between baseline and at six months was 17.26±4.36 and 17.63±21.07 respectively (p=0.0001). Greater improvement was observed in Group A..
CONCLUSIONS
Allopurinol was found to be more effective than febuxostatin reducing the left ventricular mass and left ventricular hypertrophy independent of blood pressure.
Topics: Adolescent; Adult; Aged; Allopurinol; Antimetabolites; Blood Pressure; Dose-Response Relationship, Drug; Echocardiography; Febuxostat; Female; Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Male; Middle Aged; Treatment Outcome; Ventricular Function, Left; Young Adult
PubMed: 30317339
DOI: No ID Found -
Journal of Hypertension Mar 2008The influence of left ventricular hypertrophy (LVH) on left ventricular synchronicity, and the prevalence of left ventricular dyssynchrony in hypertensive patients with...
OBJECTIVES
The influence of left ventricular hypertrophy (LVH) on left ventricular synchronicity, and the prevalence of left ventricular dyssynchrony in hypertensive patients with LVH are unknown. The purpose of this study was to determine the influence of LVH on left ventricular synchronicity in hypertensive subjects.
METHOD
Tissue Doppler imaging (TDI) was performed in 115 hypertensive and 30 control individuals. Hypertensive patients were divided into a LVH group and a non-LVH group according to the left ventricular mass index (LVMI). Diastolic and systolic asynchrony was determined by measuring the maximal differences in time to peak myocardial systolic contraction (Ts-max) and early diastolic relaxation (Te-max) between any two of the left ventricular segments and the standard deviation of time to peak myocardial systolic contraction and early diastolic relaxation of all 12 segments.
RESULTS
Ts-max was greater in both the non-LVH and LVH groups than in controls, (96.68 +/- 26.21 versus 79.30 +/- 25.19 versus 53.20 +/- 15.24 ms, both P < 0.001) and in the LVH group than in the non-LVH group (96.68 +/- 26.21 versus 79.30 +/- 25.19 ms, P < 0.01). Te-max was prolonged in both patient groups, being most advance in the LVH group (67.39 +/- 11.01 versus 57.18 +/- 11.42 versus 46.72 +/- 13.24 ms, both P < 0.001 versus control group and P < 0.001 versus non-LVH group). LVH patients had shown a greater prevalence of both systolic and diastolic asynchrony than non-LVH patients. A Ts-max value greater than 88 ms had 68% sensitivity and 71% specificity for detecting hypertensive patients with LVH.
CONCLUSION
Left ventricular systolic synchronicity was impaired in hypertensive patients with LVH. TDI was shown to be useful for the detection of myocardial abnormalities in such patients.
Topics: Adolescent; Adult; Aged; Diastole; Echocardiography, Doppler, Color; Female; Heart Ventricles; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Middle Aged; Myocardial Contraction; Systole
PubMed: 18300868
DOI: 10.1097/HJH.0b013e3282f2b91f -
Journal of the American College of... Mar 1995
Review
Topics: Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Prognosis; Ultrasonography; Ventricular Function, Left
PubMed: 7884092
DOI: 10.1016/0735-1097(94)00547-4