Natural history of congenital aortic valvar stenosis: an echo and Doppler cardiographic study

1997 ◽  
Vol 7 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Petèr Király ◽  
Livia Kapusta ◽  
Henk van Lier ◽  
Anke Otten Hofman ◽  
Otto Daniëls
Keyword(s):  
Pressure Gradient ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Sudden Increase ◽  
Older Children ◽  
Final Measurement ◽  
History Of ◽  
Ventricular Wall Thickness ◽  
Measured Pressure ◽  
Congenital Aortic Valvar Stenosis

AbstratThe availability of echo Doppler cardiography enables monitoring of the natural course of congenital aortic valvar stenosis more adequately than before. Between 1986 and 1993, 129 children with such stenosis were examined echocardiographically, 83 of them over a prolonged period with repeated studies of at least one per year. The pressure gradient between the left ventricle and ascending aorta, as well as the left ventricular wall thickness, were measured. When the pressure gradient detected increased to more than 60 mmHg, the patients were treated by balloon valvoplasty or surgical valvotomy. The last examination prior to intervention was taken as the final measurement.We found a significant increase (≥10 mmHg) in the measured pressure gradient in 40 of the 83 patients (48%). The onset of severe stenosis was not observed at a specific age, rather the stenosis was found suddenly to increase in severity at any age. The gradients measured in children younger than 2 years of age, however, increased twice as rapidly as those measured in the older children. A high gradient was not always accompanied by evidence of left ventricular hypertrophy.Based on our findings, we suggest that, since a sudden increase in severity of aortic valvar stenosis might be expected, the pressure gradient should be measured once every 6 months in children younger than 2 years of age and once a year after that age

Intraventricular pressure gradients change during the development of left ventricular hypertrophy: Effect of salvianolic acid B and beta-blocker

Ultrasound ◽  
2021 ◽  
pp. 1742271X2098758
Author(s):  
Danfu Ma ◽  
Ahmed S Mandour ◽  
Tomohiko Yoshida ◽  
Katsuhiro Matsuura ◽  
Kazumi Shimada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Left Ventricular Hypertrophy ◽  
Pressure Gradient ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Salvianolic Acid B ◽  
Intraventricular Pressure ◽  
Salvianolic Acid ◽  
Intraventricular Pressure Gradient

Introduction Intraventricular pressure gradient is regarded as a non-invasive indicator of diastolic function. Salvianolic acid B (Sal-B), a traditional Asian medicine, revealed its usefulness in myocardial infarction models; however, the hemodynamic effect of salvianolic acid B is still unknown. The present study aimed to investigate the intraventricular pressure gradient changes during the development of left ventricular hypertrophy with or without salvianolic acid B and a beta-blocker. Methods In total, 48 rats were divided into four groups; Sham, Non-treatment, salvianolic acid B, and Carvedilol. Aortic coarctation-induced left ventricular hypertrophy was done in three groups and the treatment was started from the third to the sixth week. Blood pressure, conventional echocardiography, and color M-mode echocardiography for measurement of intraventricular pressure gradient were carried out for six consecutive weeks. Results At 4.5 weeks, the LV mass was elevated in the coarctation groups but the blood pressure was significantly lower in salvianolic acid B and Carvedilol groups ( P < 0.05). In the Non-treatment group, the total intraventricular pressure gradient was increased at 4.5 and 6 weeks (2.60 and 2.65, respectively). Meanwhile, the basal intraventricular pressure gradient was elevated at 3 and 6 weeks (1.67 and 1.75) compared with the Sham group. Salvianolic acid B and Carvedilol significantly reduced the basal intraventricular pressure gradient at six weeks compared with the Non-treatment group (1.52 and 1.51 vs 1.75, respectively). Conclusions Salvianolic acid B and Carvedilol promote cardiac function by decreasing the elevated basal intraventricular pressure gradient. The current preclinical results revealed the efficacy of salvianolic acid B as a potential therapy for left ventricular hypertrophy because of the non-blood pressure lowering effect.

Penetrating Atherosclerotic Ulcer of the Aorta

2001 ◽  
Vol 8 (5) ◽  
pp. 534-538 ◽  
Author(s):  
Aditya K. Samal ◽  
Christopher J. White ◽  
James B. Kot
Keyword(s):  
Computed Tomography ◽  
Ventricular Hypertrophy ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Severe Chest Pain ◽  
Mediastinal Hematoma ◽  
History Of ◽  
Mediastinal Widening

Purpose: To describe a case of penetrating atherosclerotic ulcer of the aorta with a review of its natural history, diagnosis and management. Case Report: An elderly patient with a history of hypertension presented to the emergency room with the sudden onset of severe chest pain radiating to the back. The electrocardiogram showed left ventricular hypertrophy; the chest radiograph revealed mediastinal widening. Computed tomography was suspicious for a mediastinal hematoma without aortic dissection. Transesophageal echocardiography was also negative for dissection. An aortogram revealed a penetrating atherosclerotic ulcer of the descending thoracic aorta. The patient underwent successful resection and repair of the lesion. Conclusions: Penetrating atherosclerotic ulcer of the aorta is a potentially lethal lesion that must be promptly diagnosed and treated.

Natural history of left ventricular hypertrophy in infants of diabetic mothers

2021 ◽  
Author(s):  
Emanuele Monda ◽  
Federica Verrillo ◽  
Ippolita Altobelli ◽  
Michele Lioncino ◽  
Martina Caiazza ◽  
...  
Keyword(s):  
Natural History ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Infants Of Diabetic Mothers ◽  
History Of ◽  
Diabetic Mothers

scholarly journals Lung function and left ventricular hypertrophy in morbidly obese candidates for bariatric surgery

2015 ◽  
Vol 41 (5) ◽  
pp. 427-432
Author(s):  
Paulo de Tarso Müller ◽  
Hamilton Domingos ◽  
Luiz Armando Pereira Patusco ◽  
Gabriel Victor Guimarães Rapello
Keyword(s):  
Ventricular Hypertrophy ◽  
Relative Size ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Morbidly Obese ◽  
Small Airways ◽  
Systemic Arterial Hypertension ◽  
Posterior Wall Thickness ◽  
History Of ◽  
The Mean

Objective: To look for correlations between lung function and cardiac dimension variables in morbidly obese patients, in order to test the hypothesis that the relative size of the small airways is independently correlated with left ventricular hypertrophy. Methods: This was a retrospective study involving 192 medical records containing a clinical protocol employed in candidates for bariatric surgery between January of 2006 and December of 2010. Results: Of the 192 patients evaluated, 39 (10 males and 29 females) met the inclusion criteria. The mean BMI of the patients was 49.2 ± 7.6 kg/m2, and the mean age was 35.5 ± 7.7 years. The FEF25-75/FVC, % correlated significantly with left ventricular posterior wall thickness and relative left ventricular posterior wall thickness, those correlations remaining statistically significant (r = −0.355 and r = −0.349, respectively) after adjustment for weight, gender, and history of systemic arterial hypertension. Stepwise multivariate linear regression analysis showed that FVC and FEV1 were the major determinants of left ventricular mass (in grams or indexed to body surface area). Conclusions: A reduction in the relative size of the small airways appears to be independently correlated with obesity-related cardiac hypertrophy, regardless of factors affecting respiratory mechanics (BMI and weight), gender, or history of systemic arterial hypertension. However, FEV1 and FVC might be important predictors of left ventricular mass in morbidly obese individuals.

Genotype–phenotype analysis and natural history of left ventricular hypertrophy in LEOPARD syndrome

2008 ◽  
Vol 146A (5) ◽  
pp. 620-628 ◽  
Author(s):  
Giuseppe Limongelli ◽  
Anna Sarkozy ◽  
Giuseppe Pacileo ◽  
Paolo Calabrò ◽  
Maria Cristina Digilio ◽  
...  
Keyword(s):  
Natural History ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Leopard Syndrome ◽  
Phenotype Analysis ◽  
History Of

scholarly journals Cardiorenal continuum in hypertensive pregnancy

2009 ◽  
Vol 15 (5) ◽  
pp. 590-597
Author(s):  
I. R. Gaisin ◽  
R. M. Valeeva ◽  
N. I. Maksimov
Keyword(s):  
Pregnant Women ◽  
Ventricular Hypertrophy ◽  
Gestational Hypertension ◽  
Organ Damage ◽  
Left Ventricular ◽  
Measurement Methods ◽  
Anxiety And Depression ◽  
Pregnancy History ◽  
History Of ◽  
The Continuum

Risk factors (RF), initial stages, progression, and final stage of both cardiovascular disease (CVD) and chronic kidney disease (CKD) were analyzed in a cohort of 159 pregnant women with hypertensive disorders versus a cohort of 32 healthy pregnant controls. Cardiorenal continuum factors were separately investigated in patients with different gestational hypertension (HT) depending on the diagnostic method: 13 with isolated clinic HT (1CHT), 11 - isolated ambulatory HT (IAHT), and 18 - HT found by all three blood pressure (BP) measurement methods (clinic, ambulatory, and home BP). The number of RF (age, family history of CVD and pre-eclampsia, pre-pregnancy history of smoking, lack of physical exercise, and oral contraception, BP levels, abdominal obesity, dyslipidaemia, anxiety and depression, oxidative stress, altered fasting plasma glucose, metabolic syndrome), signs of subclinical organ damage (cell membrane destabilization, left ventricular hypertrophy, intima-media thickening, slight increase in serum creatinine, hyperuricaemia, endothelial dysfunction, albuminuria, low glomerular filtration rate), and total cardiovascular risk progressively increased from the condition of being normotensive at the time of office, home, and 24-hour measurements to the condition of being found hypertensive by one, two and all three BP measurement methods, forming the continuum «healthy pregnant women - ICHT - IAHT - gestational HT». Assessment of cardiorenal state in all pregnant women allowed to compose the cline «healthy pregnants- gestational HT- stage I essential HT - stage II essential HT - pre-eclampsia - essential HT with superimposed pre-eclampsia» with the growing risk of CVD and CKD and potential danger of cardiovascular events and chronic renal failure.

Abstract 4427: Electrocardiographic Left Ventricular Hypertrophy Predicts Long Term Fatal Outcomes in Elderly Hypertensives Despite Diuretic-Based Antihypertensive Treatment: 14-Year Follow-Up of the Systolic Hypertension in the Elderly Program (SHEP)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tudor Vagaonescu ◽  
Alan C Wilson ◽  
John B Kostis
Keyword(s):  
Antihypertensive Treatment ◽  
Ventricular Hypertrophy ◽  
Previous History ◽  
The Elderly ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
All Cause Mortality ◽  
History Of

Background: To assess if diuretic-based antihypertensive treatment improves long term fatal (cardiovascular) outcomes in the elderly with isolated systolic hypertension (ISH) and ECG documented left ventricular hypertrophy (LVH). Methods: Retrospective analysis of the SHEP database of 4,736 patients age ≥60 years and ISH and subsequent vital status ascertainment by matching to the National Death Index. Results: 348 subjects (7.35%) of SHEP participants had ECG documented LVH at baseline. Subjects with LVH had at baseline: higher SBP and pulse pressure (p<0.0001), carotid bruits (13% vs. 7%, p<0.0001) and previous history of myocardial infarction (8% vs. 4%, p=.0008) when compared with participants without LVH. There were no significant differences with regard to age, sex, heart rate, body mass index, smoking and alcohol use, previous history of stroke, diabetes, angina, and assignment to treatment or placebo group. Over 14.3 years (mean) of follow up subjects with baseline LVH experienced significantly more all cause mortality (51% vs. 40%, p<0.0001) and cardiovascular death (24% vs. 19%, p=0.002) than participants without baseline LVH. In the group of participants with LVH at baseline active treatment of hypertension did not decrease all cause mortality (51% vs. 50%, NS) or cardiovascular death (26% vs. 24%, NS). There was no statistically significant interaction between LVH and the assignment to treatment (antihypertensive medication vs. placebo). In a multivariable analysis, the adjusted Cox hazard ratio of developing any fatal outcome in the LVH group was 1.181 (95% CI 1.005–1.387, p=0.043) after adjusting for age, sex, race, history of myocardial infarction, diabetes, alcohol smoking status, education, blood pressure, and assignment to treatment or to placebo group. Conclusion: In the elderly with ISH the presence of LVH documented by ECG increased the risk for long term fatal outcomes despite treatment with diuretic-based antihypertensive therapy. Although active treatment lowered risk in the SHEP study, treated participants with LVH had a higher risk for fatal outcomes than treated subjects without LVH.

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