P1769Microvascular resistance increases with left ventricular mass in hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Bakar ◽  
S Hayman ◽  
D McCarty ◽  
A Thain ◽  
A McLellan ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Ventricular Mass ◽  
Transit Time ◽  
Microvascular Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ventricular Mass ◽  
Index Of Microvascular Resistance ◽  
Microvascular Resistance

Abstract Introduction Hypertrophic cardiomyopathy is often associated with myocardial ischemia despite lack of focal epicardial coronary stenoses and this is partially attributable to microvascular dysfunction. The index of microvascular resistance (IMR) is a hemodynamic index that is independent of epicardial stenoses and reflects coronary microvascular function. Purpose To investigate the relationship between microvascular dysfunction and the degree of hypertrophy in hypertrophic cardiomyopathy patients. Methods We performed a prospective study to assess epicardial and microvascular coronary hemodynamics in 12 subjects with hypertrophic cardiomyopathy undergoing diagnostic coronary angiography. A pressure-temperature sensor coronary guidewire was used with intracoronary injections of room-temperature saline to measure mean coronary transit time during rest and hyperemia induced with intravenous adenosine. IMR was calculated by multiplying mean coronary transit time during hyperemia by distal coronary pressure in each subject. Left ventricular mass was calculated from baseline echocardiographic studies using established methods. Continuous variables are shown as mean ± standard deviation. Results Six subjects were male; mean age was 59.8±11.6 years. Baseline body mass index was 30.5±6.1 kg/m2 and left ventricular ejection fraction was 76.7% ± 11.0% with mean left ventricular mass 230.1±76.6 grams by echocardiography. Ten subjects had asymmetric septal hypertrophy; one subject had marked apical hypertrophy and one subject had asymmetric septal and inferolateral hypertrophy. Resting left ventricular outflow tract gradient was 59.4±37.8 mmHg and increased to 90.0±54.1 mmHg with Valsalva maneuver. Systolic anterior motion of the mitral valve was present in 10 subjects. Hemodynamic variables included coronary flow reserve (2.1±1.2); hyperemic mean transit time (0.29±0.15 sec.), and IMR (21.7±10.2). Index of microvascular resistance was strongly positively correlated with left ventricular mass (Figure 1; Pearson r=0.68, p=0.021). Figure 1. IMR is correlated with LV mass Conclusion(s) Microvascular dysfunction as assessed by IMR is strongly correlated with left ventricular mass and may contribute to symptoms in patients with hypertrophic cardiomyopathy.

scholarly journals Association of serum intact fibroblast growth factor 23 with left ventricular mass and different echocardiographic findings in patients on hemodialysis

2016 ◽  
Vol 4 (3) ◽  
pp. 135-141 ◽  
Author(s):  
Amir Ahmad Nassiri ◽  
Monir Sadat Hakemi ◽  
Reza Safar-Pour ◽  
Ali Ahmadi ◽  
Maryam Tohidi ◽  
...  
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Left Ventricular Mass ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Fibroblast Growth ◽  
Ventricular Ejection Fraction ◽  
Ventricular Mass ◽  
Lv Mass

Abstract Objectives To determine the association of fibroblast growth factor 23 (FGF23) with left ventricular hypertrophy (LVH) through the assessment of left ventricular (LV) mass and left ventricular mass index (LVMI) in patients on hemodialysis, this study was done. Methods All patients on hemodialysis who are older than 18 years and in whom hemodialysis vintage was at least 6 months were enrolled. All patients were on hemodialysis thrice a week for 4 h using low-flux dialysis filters, polysulfone membranes, reverse osmosis purified water, and bicarbonate-base hemodialysis solution. The exclusion criteria were any respiratory illness or pulmonary infection, cigarette smoking, and the presence of pericarditis or pericardial effusion. Additionally, patients with a known coronary artery disease, any form of cardiac arrhythmias, any cardiomyopathy or severe valvular heart disease diagnosed by echocardiography, acute congestive heart failure (CHF), and acute myocardial infarction were not included. Echocardiography was conducted by an experienced operator for all the enrolled patients using the ACUSON SC2000™ ultrasound system transducer (Siemens), with a frequency bandwidth of: 1.5–3.5 MHz. Patients were considered to have LVH if the LVMI was greater than 134 g/m2 for men and greater than 110 g/m2 for women. Results A total of 61 patients (19 female and 42 male) were enrolled to the study. Mean (± SD) age of the patients was 59.6 ± 13.1 years. The median duration of hemodialysis was 23 (range: 6–120) months. The median predialysis level of FGF23 was 1,977 pg/mL (range: 155–8,870). LVH was seen in 73.8% of the patients (n = 45) and of them 66.7% were male. There was a statistically significant direct correlation between FGF23 and left ventricle diameter in end systole (LVDs) (r = 0.29, P = 0.027). However, the association of FGF23 with LV mass, LVMI, and left ventricular ejection fraction (LVEF) was not significant. Conclusion This study does not show the correlation between FGF23 and LV mass in stable hemodialysis patients.

scholarly journals High Vitamin K Status is Prospectively Associated with Decreased Left Ventricular Mass in Women: The Hoorn Study

2021 ◽  
Author(s):  
Joline W.J. Beulens ◽  
Elisa Dal Canto ◽  
Coen D.A. Stehouwer ◽  
Roger J.M.W. Rennenberg ◽  
Petra J.M Elders ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular Mass ◽  
Vitamin K ◽  
Left Ventricular ◽  
Matrix Gla Protein ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
High Vitamin ◽  
Ventricular Mass

Abstract Background: Vitamin K is associated with reduced cardiovascular disease risk such as heart failure, possibly by carboxylation of matrix-gla protein (MGP), a potent inhibitor of vascular calcification. The relationship of vitamin K intake or status with cardiac structure and function is largely unknown. Therefore this study aims to investigate the prospective association of vitamin K status and intake with echocardiographic measures. Methods: This study included 427 participants from the Hoorn Study, a population-based cohort. Vitamin K status was assessed at baseline by plasma desphospho-uncarboxylated MGP (dp-ucMGP) with higher concentrations reflecting lower vitamin K status. Vitamin K intake was assessed at baseline with a validated food-frequency questionnaire. Echocardiography was performed at baseline and after 7.6 years follow-up. We used linear regression for the association of vitamin K status and intake with left ventricular ejection fraction (LVEF), left atrial volume index (LAVI) and left ventricular mass index (LVMI), adjusted for potential confounders.Results: The mean age was 66.8±6.1 years (51% were male). A high vitamin K status was prospectively associated with decreased LVMI -5.0 (-10.5;0.4) g/m2.7 for the highest quartile compared to the lowest in women (P-interaction sex=0.07). No association was found in men. Vitamin K status was not associated with LVEF or LAVI. Intakes of vitamin K were not associated with any of the echocardiographic measures.Conclusions: This study indicates that a high vitamin K status is associated with decreased LVMI only in women. These results extend previous findings for a role of vitamin K status to decrease heart failure risk.

scholarly journals Hyperuricemia Is Associated with Left Ventricular Dysfunction and Inappropriate Left Ventricular Mass in Chronic Kidney Disease

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 514
Author(s):  
Tai-Hua Chiu ◽  
Pei-Yu Wu ◽  
Jiun-Chi Huang ◽  
Ho-Ming Su ◽  
Szu-Chia Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Left Ventricular Mass ◽  
Left Ventricular ◽  
High Serum ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Ventricular Mass ◽  
Echocardiographic Parameters

Background. Hyperuricemia is common in patients with chronic kidney disease (CKD), and this may lead to poor cardiovascular (CV) outcomes. The aim of this cross-sectional study was to assess associations among serum uric acid (UA) and echocardiographic parameters, ankle-brachial index (ABI), and brachial-ankle pulse wave velocity (baPWV) in patients with CKD. Methods. A total of 418 patients with CKD were included. The echocardiographic measurements included left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and the ratio of observed to predict left ventricular mass (LVM). ABI, baPWV and medical records were obtained. Results. Multivariable forward logistic regression analysis showed that a high UA level was significantly associated with LAD > 47 mm (odds ratio [OR], 1.329; p = 0.002), observed/predicted LVM > 128% (OR, 1.198; p = 0.008) and LVEF < 50% (OR, 1.316; p = 0.002). No significant associations were found between UA and ABI < 0.9 or baPWV > 1822 cm/s. Multivariate stepwise linear regression analysis showed that a high UA level correlated with high LAD (unstandardized coefficient β, 0.767; p < 0.001), high observed/predicted LVM (unstandardized coefficient β, 4.791; p < 0.001) and low LVEF (unstandardized coefficient β, −1.126; p = 0.001). No significant associations between UA and low ABI and high baPWV were found. Conclusion. A high serum UA level was associated with a high LAD, high observed/predicted LVM and low LVEF in the patients with CKD. A high serum UA level may be correlated with abnormal echocardiographic parameters in patients with stage 3–5 CKD.

Left ventricular size and systolic function in Thoroughbred racehorses and their relationships to race performance

2005 ◽  
Vol 99 (4) ◽  
pp. 1278-1285 ◽  
Author(s):  
L. E. Young ◽  
K. Rogers ◽  
J. L. N. Wood
Keyword(s):  
Left Ventricular Mass ◽  
Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Size ◽  
Ventricular Ejection Fraction ◽  
Left Ventricular Size ◽  
Ventricular Mass ◽  
Thoroughbred Racehorses ◽  
Competition Result

Cardiac morphology in human athletes is known to differ, depending on the sports-specific endurance component of their events, whereas anecdotes abound about superlative athletes with large hearts. As the heart determines stroke volume and maximum O2 uptake in mammals, we undertook a study to test the hypothesis that the morphology of the equine heart would differ between trained horses, depending on race type, and that left ventricular size would be greatest in elite performers. Echocardiography was performed in 482 race-fit Thoroughbreds engaged in either flat (1,000–2,500 m) or jump racing (3,200–6,400 m). Body weight and sex-adjusted measures of left ventricular size were largest in horses engaged in jump racing over fixed fences, compared with horses running shorter distances on the flat (range 8–16%). The observed differences in cardiac morphologies suggest that subtle differences in training and competition result in cardiac adaptations that are appropriate to the endurance component of the horses' event. Derived left ventricular mass was strongly associated with published rating (quality) in horses racing over longer distances in jump races ( P ≤ 0.001), but less so for horses in flat races. Rather, left ventricular ejection fraction and left ventricular mass combined were positively associated with race rating in older flat racehorses running over sprint (<1,408 m) and longer distances (>1,408 m), explaining 25–35% of overall variation in performance, as well as being closely associated with performance in longer races over jumps (23%). These data provide the first direct evidence that cardiac size influences athletic performance in a group of mammalian running athletes.

scholarly journals Myocardial work: a new way to predict fibrosis in patients with hypertrophic cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Valentim Goncalves ◽  
S Aguiar Rosa ◽  
L Moura Branco ◽  
A Galrinho ◽  
A Fiarresga ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Global Longitudinal Strain ◽  
Left Ventricular Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Prognostic Information ◽  
Ventricular Ejection Fraction ◽  
Significant Fibrosis ◽  
Constructive Work ◽  
Global Work

Abstract Aims Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) adds prognostic information in patients with hypertrophic cardiomyopathy (HCM). Whether Myocardial work (MW), a new parameter on transthoracic echocardiographic (TTE), can predict significant fibrosis in HCM patients is unknown. Methods Single-centre evaluation of consecutively recruited HCM patients in which TTE and CMR were performed. MW and related indices were calculated from global longitudinal strain (GLS) and from estimated left ventricular pressure curves. The extent of LGE was quantitatively assessed. LGE ≥15% was chosen to define significant fibrosis. Logistic regression analysis was used to find the variables associated with LGE ≥15% and cut-off values were determined. Results Among the thirty-two patients analysed mean age was 57±16 years, 18 (56%) were male patients and the mean left ventricular ejection fraction by TTE was 67±8%. Global constructive work (GCW), global work index and GLS were significant predictors of LGE ≥15%. A cut-off ≤1550 mmHg% of GCW was able to predict significant fibrosis with a sensitivity of 92% and a specificity of 79%, while the best cut-off for GLS (&gt;−15%) had a sensitivity of 86% and a specificity of 72%. Conclusion GCW was the best parameter to predict significant left ventricular myocardial fibrosis in CMR, suggesting its utility in patients who may not be able to have a CMR study. Myocardial Work and LGE in CMR in HCM Funding Acknowledgement Type of funding source: None

Abstract 11093: Layer-specific Quantification of Myocardial Deformation by Strain Echocardiography May Reveal the Mechanism of Preserved Left Ventricular Ejection Fraction in Patients With Hypertrophic Cardiomyopathy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jing Ping Sun ◽  
Xianda Ni ◽  
Tingyan Xu ◽  
Min Xu ◽  
Xing Sheng Yang ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Ejection Fraction ◽  
Wall Thickness ◽  
Radial Strain ◽  
Left Ventricular ◽  
Relative Wall Thickness ◽  
Left Ventricular Ejection ◽  
Compensatory Mechanisms ◽  
Ventricular Ejection Fraction ◽  
Bull's Eye

Purpose: We aimed to evaluate compensatory mechanisms in hypertrophic cardiomyopathy (HCM) patients (pts) with preserved left-ventricular (LV) ejection fraction (EF). Methods: Speckle-tracking echocardiography (Vivid E9, GE) was performed in 50 HCM with preserved LV EF (38 m; 49± 14 y, all LV EF > 55%) and 50 age, gender matched controls (38 m; 49±12 y). The global and segmental longitudinal (LS), circumferential (CS) and radial strain (RS) strains of endocardia (End), mid-wall and epicardia layers were analyzed using a novel layer-specific TTE. The ratio of End to epicardia strain (End/Epi) was calculated. Results: The LV EF were similar in pts and controls (64±8 vs 64±7 %, p=0.95). The diastolic function was significantly impaired in HCM pts compared with controls (E/E’:18.4±8.4 vs 8.6 ±2.4, p<0.0001). The absolute value of LS and CS was reserved at apical End layers (-34±7 vs -35±6, p=0.44); the remaining segments and LV global LS and CS of three layers were significantly smaller (LS,-16±5 vs -22±3; CS -24±8 vs -33±7; p<0.0001), and LS and CS End/Epi (1.7±0.3 vs 1.3±0.1, 3.4±1.1 vs 1.7±0.2 respectively, P <0.0001) was significantly higher in HCM pts than in controls. The RS and LV twist were preserved in all LV segments (27±10 vs 24±12, p=0.19; 20±8 vs 18±5, p=0.33; respectively). In HCM pts, the LV LS value at basal and middle levels revealed significant negative correlations with LV relative wall thickness (r=–0.65, –0.59 and –0.60, –0.54, respectively , p< 0.0001); and mild negative correlations (r=-0.33,-0.29, p<0.0001). The LV CS value at all levels revealed mild correlations with relative wall thickness (r=-0.22, p<0.05) . The LS were significantly reduced at the hypertrophic segments (Figure). Conclusions: In HCM patients with preserved LVEF, LV GLS was impaired, but apical End LS and basal End CS, LV RS as well as LV twist were maintained as the compensation for reduction LV LS and CS. The Bull’s eye of LS may help us to localize the lesion segments and define the type of HCM.

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