Role of left ventricular geometry in the alteration of initial QRS vectors due to concentric ventricular hypertrophy

1994 ◽  
Vol 27 (4) ◽  
pp. 301-309 ◽  
Author(s):  
Ivan Ruttkay-Nedecký ◽  
Eva Vanžurová ◽  
Vavrinec Szathmáry ◽  
Katarína Kanáliková ◽  
Róbert Osvald
2010 ◽  
Vol 3 (2) ◽  
pp. 164-171 ◽  
Author(s):  
Michel G. Khouri ◽  
Ronald M. Peshock ◽  
Colby R. Ayers ◽  
James A. de Lemos ◽  
Mark H. Drazner

2021 ◽  
Vol 6 (5) ◽  

Background: Cardiac percussion (CP) is a bedside technique to evaluate cardiac borders and chamber size. Although advanced cardiac imaging has revolutionized the methods to detect cardiomegaly, art of CP remains the most convenient option, especially in emergent situations. Although transthoracic echocardiography (TTE) is considered the gold standard to determine left ventricular (LV) size, CP can estimate LV size with equal accuracy as TTE in appropriate clinical setting. The aim of this study was to investigate the correlation of LV size assessed by CP technique versus standard TTE, as well as cardiothoracic ratio (CTR) on chest roentgenography (CXR). Methods: This descriptive study was conducted on Telemetry units. Patients were positioned in supine position at Gatch angle of 30-45 degrees. Cardiac dullness was measured in cm by percussing from mid clavicular line towards gladiolus of sternal body. Subsequently, findings were correlated with TTE dimensions of left ventricular end-diastolic diameter (LVEDD). Results: In 200 patients, mean age was 63+15.8 years, with 51% females. The LV diameter (LVD) measured by CP technique was observed to be similar to LVEDD measured by TTE (Mean- 4.65+0.67 cm versus 4.69+0.76 cm, COV 7.6%). The BlandAltman comparison of CP technique and TTE measurements indicated significant differences in variances between the two measures (r=0.270, p=<0.001). The LVD measured by CXR did not show correlation with LVEDD (5.79+1.21 cm, COV 14.3%) with significant differences in the variances between the two measures (r=-0.475, p<0.001). The LV volumes measured by CP technique were observed to have correlation with LV volumes measured by TTE (COV 14.9%). Conclusion: CP technique is a convenient bedside method that can be utilized to assess LVD and volume. It is shown to have a precise correlation with LVEDD measured by TTE. The study emphasizes role of bedside estimation of LV size by using the art of physical examination.


Author(s):  
R.R. Guta ◽  
N.S. Beck ◽  
O.M. Radchenko

Introduction. For a patient with coronary heart disease, recovery from myocardial revascularization is a complex process. Cardiac remodeling involves, after myocardial infarction, hypertrophy and dilation, resulting in impaired systolic-diastolic cardiac function, which is an additional risk factor for events. Prospective studies have shown a relationship between left ventricular size and the risk of cardiovascular events. Given this, there was a need to conduct our research. Purpose: To determine the prevalence of types of left ventricular geometry in patients with coronary heart disease, post-infarction cardiosclerosis, depending on therapeutic tactics: revascularization or conservative therapy for 60 months. Material and Methods: We examined 101 patients aged 58.6±4.2 years after myocardial revascularization (n = 71) and with conservative treatment only (n = 30), in whom the dynamics of echocardiographic parameters of the heart were evaluated for 5 years. The values ​​of remodeling myocardial mass index of the left ventricle and the relative thickness of the left ventricle were determined. Results and Discussion. At baseline, patients with concentric left ventricular hypertrophy (50.0%) and concentric remodeling (24.1%) predominated in the main group. Normal geometry in 14.8% and eccentric left ventricular hypertrophy were observed in 11.1%. In the comparison group, eccentric hypertrophy and concentric left ventricular remodeling were most commonly observed, 29.6% each, slightly less than 25.9% concentric hypertrophy, and the least was normal geometry (14.8%). After 60 months, patients with both groups did not experience normal left ventricular geometry and concentric remodeling. The concentric type (80.0%) was predominant in the main group, and the eccentric type (55.6%) in the comparison group. Conclusions. In patients with ischemic heart disease, postinfarction cardiosclerosis progresses in 5 year follow-up myocardial hypertrophy regardless of treatment. After revascularization, concentric left ventricular hypertrophy develops more often, whereas under conservative treatment, left ventricular eccentric hypertrophy is combined with systolic dysfunction and left atrial dilatation. After revascularization, an increase in the index was associated with an increase not only in body weight but also in changes in lipid profile and diastolic hypertension.


2020 ◽  
Author(s):  
Bojko Bjelakovic ◽  
Claudia Stefanutti ◽  
Vladimir Vukovic ◽  
Nebojsa Kavaric ◽  
Ljiljana Saranac ◽  
...  

Abstract Background: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children. Patients and methods : In this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these values TG / HDL ratio, BMI and HOMA index were calculated. We also measured the average 24-hour ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses with stepwise selection were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex. Results : Our study included 70 children (65.71% boys and 34.29% girls) with median age (14 years, IQR=12-16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24h-average SBP with LVMI (effect=3.65, SE=1.32, p<0.01; effect=34.90, SE=6.84, p<0.01; effect=0.32, SE=0.12, p<0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect=13.07, SE=5.02, p=0.01 Insulin: effect=2.80, SE=0.97). Conclusion: Increased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy.


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