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Journal of the American Society of... Feb 2011Systolic reserve is an important compensatory mechanism against increasing afterload. Although longitudinal systolic dysfunction with preserved ejection fraction has... (Comparative Study)
Comparative Study
Left ventricular hypertrophy causes different changes in longitudinal, radial, and circumferential mechanics in patients with hypertension: a two-dimensional speckle tracking study.
BACKGROUND
Systolic reserve is an important compensatory mechanism against increasing afterload. Although longitudinal systolic dysfunction with preserved ejection fraction has been reported in hypertensive hearts, radial and circumferential function has not been fully examined. The aim of this study was to investigate three-directional systolic function and its relationships with left ventricular geometry in asymptomatic hypertensive patients using two-dimensional speckle-tracking imaging.
METHODS
Echocardiographic evaluations were performed in 74 hypertensive patients and 55 age-matched control subjects.
RESULTS
Longitudinal strain was significantly reduced in the hypertrophy groups compared with that in control subjects (concentric, -15.1 ± 4.0%; eccentric, -15.9 ± 4.4%; control, -18.9 ± 3.3%; P < .05). Conversely, radial strain was significantly higher in the normal geometry group than in control subjects (53.8 ± 19.4% vs 40.3 ± 15.1%, P < .05). However, this augmentation was attenuated in the other geometries.
CONCLUSION
Hypertrophic remodeling attenuates compensatory augmentation of radial systolic function and is associated with latent longitudinal systolic dysfunction.
Topics: Echocardiography, Doppler; Elastic Modulus; Elasticity Imaging Techniques; Female; Heart Ventricles; Humans; Hypertension; Hypertrophy, Left Ventricular; Male; Middle Aged; Stress, Mechanical
PubMed: 21145703
DOI: 10.1016/j.echo.2010.10.020 -
Chest Jun 1983
Topics: Angiography; Cardiomegaly; Echocardiography; Electrocardiography; Heart Ventricles; Humans; Prognosis
PubMed: 6221891
DOI: 10.1378/chest.83.6.838a -
Biochemical and Biophysical Research... Feb 1998There is evidence that insulin-like growth factor-1 (IGF-1) plays a role in the development of left ventricular hypertrophy, but it is uncertain whether cardiac IGF-1...
There is evidence that insulin-like growth factor-1 (IGF-1) plays a role in the development of left ventricular hypertrophy, but it is uncertain whether cardiac IGF-1 changes before or after hypertension is established, and whether circulating IGF-1 are involved in cardiac hypertrophy. We have investigated changes in circulating and left ventricular IGF-1 and in the expression of the IGF-1 gene in the left ventricles of rats during the development of hypertensive left ventricular hypertrophy (Goldblatt model; 2 kidney-1 clamped). Our results show that the left ventricular contents of IGF-1 and its mRNA were increased at one and four weeks of hypertension and hypertrophy, and that both returned to control values after nine weeks. These changes were unrelated to the seric concentration of IGF-1 in the blood. These results show that local rather than circulating IGF-1 levels contributed to the development of renovascular hypertensive left ventricular hypertrophy.
Topics: Animals; Disease Models, Animal; Gene Expression; Heart Ventricles; Hypertension, Renovascular; Hypertrophy, Left Ventricular; Insulin-Like Growth Factor I; Male; Myocardium; Rats; Rats, Sprague-Dawley; Time Factors
PubMed: 9473472
DOI: 10.1006/bbrc.1997.8031 -
Pediatrics International : Official... Apr 1999Measurement of left ventricular mass (LVM) is important to the diagnosis of left ventricular hypertrophy in children with various cardiovascular diseases. The purpose of...
BACKGROUND
Measurement of left ventricular mass (LVM) is important to the diagnosis of left ventricular hypertrophy in children with various cardiovascular diseases. The purpose of this study was to determine the most appropriate method for standardization of LVM and to evaluate obesity-induced left ventricular hypertrophy in children across the entire age range, from infancy through adolescence.
METHODS
We studied 928 children and adolescents (527 males, 401 females), aged 0-17 years, who were classified into two groups by degree of obesity. Left ventricular mass was calculated by M-mode echocardiography using the formula of Devereux et al. and was indexed using body size (body length, bodyweight or body surface area) raised to a non-integer power using logarithmic transformation of measurements in children without obesity.
RESULTS
The body length, bodyweight and body surface area exponents were 1.85, 0.88 and 1.15, respectively, in males, and 1.72, 0.82 and 1.08, respectively, in females. Whereas indexing of left ventricular mass by body length both in males and in females revealed significant differences between the two groups, indexing using bodyweight or body surface area exponents did not manifest left ventricular hypertrophy induced by obesity.
CONCLUSION
It is suggested that applying body length exponents 1.85 in males and 1.72 in females is an appropriate method for indexation of LVM in children and adolescents. This method is particularly useful for the evaluation of left ventricular hypertrophy in children.
Topics: Adolescent; Body Constitution; Body Weight; Child; Child, Preschool; Echocardiography; Female; Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Infant; Infant, Newborn; Male; Obesity; Reference Values
PubMed: 10221013
DOI: 10.1046/j.1442-200x.1999.4121047.x -
La Revue Du Praticien Mar 1992
Topics: Cardiomegaly; Heart Ventricles; Humans; Hypertension; Prognosis
PubMed: 1534632
DOI: No ID Found -
Cardiovascular Research Dec 2003
Topics: Animals; Electrophysiology; Heart Rate; Heart Ventricles; Humans; Hypertension; Hypertrophy, Left Ventricular; Treatment Outcome
PubMed: 14659790
DOI: 10.1016/j.cardiores.2003.10.015 -
Anatomical Record (Hoboken, N.J. : 2007) May 2009The three-dimensional architecture of the right ventricular myocardium is a major determinant of function, but as yet no investigator-independent methods have been used...
Normal right ventricular three-dimensional architecture, as assessed with diffusion tensor magnetic resonance imaging, is preserved during experimentally induced right ventricular hypertrophy.
The three-dimensional architecture of the right ventricular myocardium is a major determinant of function, but as yet no investigator-independent methods have been used to characterize either the normal or hypertrophied state. We aimed to assess and compare, using diffusion tensor magnetic resonance imaging, the normal architecture with the arrangement induced by chronic hypertrophy. We randomized 20 female 5 kg piglets into pulmonary trunk banding (N = 16) and sham operation (N = 4). Right ventricular hypertrophy was assessed after 8 weeks. The excised and fixed hearts were subject to diffusion tensor imaging to determine myocyte helical angles, and the presence of any reproducible tracks formed by the aggregated myocytes. All banding animals developed significant right ventricular hypertrophy, albeit that no difference was observed in terms of helical angles or myocardial pathways between the banded animals and sham group animals. Helical angles varied from approximately 70 degrees endocardially to -50 degrees epicardially. Very few tracks were circular, with helical angles approximating zero. Reproducible patterns of chains of aggregated myocytes were observed in all hearts, regardless of group. The architecture of the myocytes aggregated in the walls of the right ventricle is comparable to that found in the left ventricle in terms of endocardial and epicardial helical angles, however the right ventricle both in the normal and the hypertrophied state lacks the extensive zone of circular myocytes seen in the mid-portion of the left ventricular walls. Without such beneficial architectural remodelling, the porcine right ventricle seems unsuited structurally to sustain a permanent increase in afterload.
Topics: Algorithms; Animals; Cell Proliferation; Diffusion Magnetic Resonance Imaging; Disease Models, Animal; Endocardium; Female; Heart Ventricles; Hypertrophy, Right Ventricular; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Models, Anatomic; Models, Cardiovascular; Myocardium; Myocytes, Cardiac; Pulmonary Circulation; Software; Sus scrofa
PubMed: 19306437
DOI: 10.1002/ar.20873 -
Pflugers Archiv : European Journal of... Jun 2014Although pulmonary arterial hypertension originates in the lung and is caused by progressive remodeling of the small pulmonary arterioles, patients die from the... (Review)
Review
Although pulmonary arterial hypertension originates in the lung and is caused by progressive remodeling of the small pulmonary arterioles, patients die from the consequences of pressure-overload-induced right heart failure. Prognosis is poor, and currently there are no selective treatments targeting the failing right ventricle. Therefore, it is of utmost importance to obtain more insights into the mechanisms of right ventricular adaptation and the transition toward right heart failure. In this review, we propose that the same adaptive mechanisms, which initially preserve right ventricular systolic function and maintain cardiac output, eventually initiate the transition toward right heart failure.
Topics: Adaptation, Physiological; Animals; Glycolysis; Heart Failure; Heart Ventricles; Humans; Hypertension, Pulmonary; Hypertrophy, Right Ventricular; Vascular Resistance
PubMed: 24488007
DOI: 10.1007/s00424-014-1450-1 -
Heart, Lung & Circulation Mar 2017Obesity has been found to be a predictor of left ventricular hypertrophy (LVH). However, studies which divide obesity into metabolically healthy obesity (MHO) and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Obesity has been found to be a predictor of left ventricular hypertrophy (LVH). However, studies which divide obesity into metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) to study the effect of obesity on LVH have been rare. The present study aims to make clear the effects of various obese phenotypes and metabolic abnormalities on LVH.
METHODS
A total of 10,804 participants were involved in this cross-sectional study. "Obesity" and "metabolically healthy" were defined as BMI ≥ 25kg/m and having none of the metabolic factors respectively.
RESULTS
It was found that metabolically unhealthy non-obesity (MUNO) (OR, 2.675; 95%CI, 1.603-4.462, P < 0.001) and MUO (OR, 9.067; 95%CI, 5.474-15.020, P<0.001) were significantly associated with LVH, while it went in reverse for MHO (OR, 1.968; 95%CI, 0.560-6.920, P=0.291), after adjustment for age, race, gender, educational status, physical activity, annual income, current smoking status, current drinking status, sleep duration and BMI. And after further adjustment for metabolic abnormalities, MUNO (OR, 0.567; 95%CI, 0.316-1.018, P=0.794) and MUO (OR, 0.632; 95%CI, 0.342-1.166, P=0.142) tended not to be associated with LVH any longer. However, among the five metabolic components of metabolic abnormalities, high blood pressure (OR, 4.358; 95%CI, 3.266-5.815, P<0.001) and high waist circumference (OR, 1.530; 95%CI, 1.139-2.054, P=0.005) were significantly associated with LVH.
CONCLUSIONS
Metabolic abnormalities, but not MHO, were significantly associated with LVH. In addition, metabolic abnormalities were probable to mediate the connection between MUNO/MUO and LVH.
Topics: Adult; Aged; Cross-Sectional Studies; Female; Heart Ventricles; Humans; Hypertrophy, Left Ventricular; Male; Middle Aged; Obesity
PubMed: 27555052
DOI: 10.1016/j.hlc.2016.06.1212 -
American Heart Journal May 2001Predicted left ventricular (LV) mass for sex, height (2.7), and hemodynamic load can be used as an intrapatient reference for the observed LV mass. The ratio of... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
BACKGROUND
Predicted left ventricular (LV) mass for sex, height (2.7), and hemodynamic load can be used as an intrapatient reference for the observed LV mass. The ratio of observed/predicted LV mass may allow more physiologically correct comparisons of LV geometry, systolic and diastolic functions, and hemodynamics among hypertensive patients.
METHODS
We studied 659 participants in the LIFE (Losartan Intervention for Endpoint Reduction in Hypertension) study with both electrocardiographic and echocardiographic LV hypertrophy (68% of the echocardiographic cohort) without previous myocardial infarction. LV mass was predicted by an equation including sex, stroke work, and height (2.7). Observed/predicted LV mass > 128% defined inappropriate LV hypertrophy (iLVH). Relative wall thickness > or = 0.43 defined concentric LV geometry. Systolic myocardial dysfunction was assessed by midwall mechanics and abnormal LV relaxation by isovolumic relaxation time (IVRT).
RESULTS
Compared with patients with appropriate LV hypertrophy (aLVH), those with iLVH had higher body mass index, LV mass index, relative wall thickness, prevalences of systolic myocardial dysfunction and prolonged IVRT and lower end-systolic stress and cardiac index. Patients with eccentric iLVH had the highest wall stress and lowest ejection fraction; 43% had systolic myocardial dysfunction. Of patients with concentric iLVH, 79% had systolic myocardial dysfunction but normal ejection fraction and the lowest wall stress. Systolic myocardial dysfunction was present in 12% with concentric aLVH and none with eccentric aLVH. Prevalence of prolonged IVRT was high in all 4 groups (65% to 77%). Cardiac index was similarly lower with concentric or eccentric iLVH than with aLVH.
CONCLUSIONS
Among hypertensives with LV hypertrophy, iLVH identified cardiac phenotypes with a high prevalence of myocardial systolic dysfunction.
Topics: Aged; Aged, 80 and over; Antihypertensive Agents; Disease Progression; Echocardiography, Doppler; Electrocardiography; Female; Heart Ventricles; Hemodynamics; Humans; Hypertension; Hypertrophy, Left Ventricular; Losartan; Male; Middle Aged; Prognosis; Ventricular Function, Left
PubMed: 11320367
DOI: 10.1067/mhj.2001.114803