scholarly journals RARE-59. CARDIAC REMODELING IN PATIENTS WITH CHILDHOOD-ONSET CRANIOPHARYNGIOMA – RESULTS OF HIT-ENDO AND KRANIOPHARYNGEOM 2000/2007

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii455-iii455
Author(s):  
Panjarat Sowithayasakul ◽  
Leona Katharin Buschmann ◽  
Svenja Boekhoff ◽  
Hermann L Müller
Keyword(s):  
Cardiac Remodeling ◽  
Disease Duration ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Internal Diameter ◽  
Functional Impairments ◽  
Childhood Onset ◽  
Anthropometric Parameters ◽  
Hypothalamic Obesity ◽  
Wide Range

Abstract BACKGROUND Hypothalamic obesity caused by childhood–onset craniopharyngioma results in long–term cardiovascular morbidity. Knowledge about clinical markers and risk factors is rare. PATIENTS AND METHODS A cross–sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 patients with childhood-onset adamantinomatous craniopharyngioma. RESULTS Body mass index (BMI) correlated with the thickness of interventricular septum in diastole (IVSd) (r=0.604, p<0.001) and left ventricular diastolic posterior wall in diastole (LVPWd) (r=0.460, p=0.011). Due to wide range of disease duration, 17 pediatric and 19 adult patients were analyzed separately. In the adult subgroup (age at study ≥18 years), BMI correlated with IVSd (r=0.707, p=0.003), LVPWd (r=0.592, p=0.020) and left ventricular internal diameter in diastole (LVIDd) (r=0.571, p=0.026). In the pediatric subgroup (age at study <18 years), no correlation between cardiac parameters and BMI was observed. Only LVIDd correlated with disease duration (r=0.645, p<0.001). All cardiac functions were within the normal range, indicating no association with severe functional impairments. CONCLUSIONS Cardiac remodeling in patients with childhood-onset craniopharyngioma correlates with the degree of hypothalamic obesity and disease duration. However, echocardiography has limited sensitivity in craniopharyngioma patients with obesity, so cardiac magnetic resonance imaging (MRI) should be considered as an alternative diagnostic approach for patients with craniopharyngioma and hypothalamic obesity.

scholarly journals Cardiac remodeling in patients with childhood-onset craniopharyngioma—results of HIT-Endo and KRANIOPHARYNGEOM 2000/2007

2021 ◽  
Author(s):  
Panjarat Sowithayasakul ◽  
Leona Katharin Buschmann ◽  
Svenja Boekhoff ◽  
Hermann L. Müller
Keyword(s):  
Insulin Resistance ◽  
Cardiac Remodeling ◽  
Disease Duration ◽  
Hormone Replacement ◽  
Left Ventricular ◽  
Male Gender ◽  
Sex Hormone ◽  
Childhood Onset ◽  
Anthropometric Parameters ◽  
Hypothalamic Obesity

AbstractHypothalamic obesity caused by childhood-onset craniopharyngioma results in long-term cardiovascular morbidity. Knowledge about clinical markers and risk factors for cardiovascular morbidity is scarce. A cross-sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 craniopharyngioma patients. BMI correlated with the thickness of interventricular septum in diastole (IVSd) (r = 0.604, p < 0.001) and left ventricular posterior wall thickness in diastole (LVPWd) (r = 0.460, p = 0.011). In multivariate analyses on risk factors for cardiac remodeling, sex hormone replacement therapy, BMI, and male gender were positively correlated with increased left ventricular internal diameter in diastole (LVIDd), R2 = 0.596, F = 10.323, p < 0.001. BMI and insulin resistance were selected as significant independent determinants of IVSd, produced R2 = 0.655, F = 29.441, p < 0.001. Due to a wide range of disease duration, 17 pediatric and 19 adult patients were analyzed separately. In the adult subgroup (age at study ≥ 18 years), BMI correlated with IVSd (r = 0.707, p = 0.003), LVPWd (r = 0.592, p = 0.020), and LVIDd (r = 0.571, p = 0.026). In the pediatric subgroup (age at study < 18 years), no correlation between transthoracic echocardiography (TTE) parameters and BMI was observed. Only LVIDd correlated with disease duration (r = 0.645, p < 0.001). All cardiac functions were within the normal range, indicating no association with functional impairments.Conclusion: Cardiac remodeling in patients with craniopharyngioma correlated with the degree of hypothalamic obesity, disease duration, sex hormone replacement therapy, male gender, and insulin resistance. As echocardiography has limited sensitivity in patients with obesity, further research on more sensitive techniques for cardiac diagnostics in craniopharyngioma patients is warranted. What is Known:•Long-term prognosis in survivors of craniopharyngioma is impaired by obesity and cardiovascular disease.•Associations between echocardiographic findings and clinical and anthropometric parameters after craniopharyngioma are not yet analyzed. What is New:•In patients with childhood-onset craniopharyngioma, cardiac remodeling was associated with hypothalamic obesity, duration of disease, male gender sex hormone replacement, and insulin resistance.•Due to reduced echocardiographic sensitivity caused by obesity-related technical limitations, more sensitive cardiac diagnostics should be considered.

scholarly journals Cardiac Remodeling in Patients with Childhood-Onset Craniopharyngioma - Results of HIT-Endo and KRANIOPHARYNGEOM 2000/2007

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A638-A639
Author(s):  
Panjarat Sowithayasakul ◽  
Leona Katharin Buschmann ◽  
Svenja Boekhoff ◽  
Hermann Lothar Muller
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Hormone Replacement Therapy ◽  
Cardiac Remodeling ◽  
Disease Duration ◽  
Hormone Replacement ◽  
Left Ventricular ◽  
Male Gender ◽  
Childhood Onset ◽  
Hypothalamic Obesity

Abstract Hypothalamic obesity caused by childhood-onset craniopharyngioma results in long-term cardiovascular morbidity. Knowledge about clinical markers and risk factors is rare. A cross-sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 craniopharyngioma patients recruited in HIT-Endo and KRANIOPHARYNGEOM 2000/2007. BMI correlated with the thickness of interventricular septum in diastole (IVSd) (r=0.604, p&lt;0.001) and left ventricular posterior wall thickness in diastole (LVPWd) (r=0.460, p=0.011). In multivariate analyses on risk factors for cardiac remodeling, sex hormone replacement therapy, BMI and male gender were positively correlated with increased left ventricular internal diameter in diastole (LVIDd), R2=0.596, F=10.323, p&lt;0.001. BMI and insulin resistance were selected as significant independent determinants of IVSd, produced R2=0.655, F=29.441, p&lt;0.001. Due to wide range of disease duration, 17 pediatric and 19 adult patients were analyzed separately. In the adult subgroup (age at study ≥18 years), BMI correlated with IVSd (r=0.707, p=0.003), LVPWd (r=0.592, p=0.020) and LVIDd (r=0.571, p=0.026). In the pediatric subgroup (age at study &lt;18 years), no correlation between cardiac parameters and BMI was observed. Only LVIDd correlated with disease duration (r=0.645, p&lt;0.001). All cardiac functions were within the normal range, indicating no association with functional impairments. We conclude that cardiac remodeling in patients with childhood-onset craniopharyngioma correlated with the degree of hypothalamic obesity, disease duration, sex hormone replacement therapy, male gender and insulin resistance. As echocardiography has limited sensitivity in patients with obesity, further research on more sensitive techniques for cardiac diagnostics in craniopharyngioma patients is warranted.

scholarly journals Echocardiographic Assessment of Cardiac Structural and Functional Indices in Broiler Chickens Treated with Silver Nanoparticles

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Hamid Raieszadeh ◽  
Vahid Noaman ◽  
Mehrdad Yadegari
Keyword(s):  
Broiler Chickens ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Internal Diameter ◽  
Treatment Groups ◽  
Randomized Design ◽  
Linear Probe ◽  
Significant Difference ◽  
Echocardiographic Assessment ◽  
Fractional Shortening

270 Ross broiler chickens of twenty days old were housed in 18-floor pens in a completely randomized design with six treatment groups and three replicate groups and fifteen chicks per each pen. The treatment groups (1–6) consisted of 0, 10, 20, 30, 50, and 70 ppm of nanocide in drinking water, respectively. At 26 days of age, 3 chickens were selected randomly for echocardiography using a 7.5 MHz linear probe, and the left ventricular internal diameter at the end of diastole (LVIDd), left ventricular internal diameter at the end of systole (LVIDs), left ventricular fractional shortening (LVFS), ejection fraction (EF), stroke volume (SV), interventricular septum thickness at the end of systole (IVSTs), and interventricular septum thickness at the end of diastole (IVSTd) were evaluated. LVIDd and LVIDs in group six were of higher rate than other groups and showed statistically significant differences with groups two, three, and four (P<0.05). LVFS, percentage of EF, and IVSTd were minimum in group six and had significant difference with other groups (P<0.05). The results of this study showed that prescription of high dosage of nanocide leads to cardiovascular problems with decrease in myocardial contractility and increase in the internal diameter of left ventricle.

scholarly journals P955 left ventricle cardiac remodeling among lithuanian football versus basketball players

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Aldujeli ◽  
J Laukaitiene ◽  
R Unikas
Keyword(s):  
Left Ventricle ◽  
Wall Thickness ◽  
Cardiac Remodeling ◽  
Interventricular Septum ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Relative Wall Thickness ◽  
Football Players ◽  
Basketball Players ◽  
Lv Mass

Abstract Background Regular physical exercise causes a continuous gradual increase of the cardiac left ventricular (LV) mass known as physiological adaptive hypertrophy. The extent of LV remodeling depends on the type, amount, and intensity of the exercise. Purpose The aim of this study was to compare structural changes of the heart among Lithuanian football, basketball players and unathletic controls. Methods A total of 50 Lithuanian males aged between 20-29 years volunteered to participate in the study. Football players (n = 15) playing for local II league football clubs,and Basketball players (n = 15) playing for local minor league basketball teams. All athletes had been regularly engaged in their sport for at least three years. Inactive healthy volunteers (n = 20) of similar age served as controls. Routine transthoracic echocardiographic examinations to measure end-diastolic LV dimensions were performed by cardiology fellow under the supervision of a fully licensed cardiologist. Statistical analyses were performed using the SPSS 20.0 software. The value of p &lt; 0,05 was considered as statistically significant. Results No structural or functional pathologies were evident during the echocardiographic examination in any of the subjects. Absolute interventricular septum (IVS) thickness and LV posterior wall thickness, but not LV diameter, were higher in athletes than in inactive controls (P &lt; 0,001). Indexed LV diameter was higher in football players as compared with non-athlete controls and basketball players (P &lt; 0,05). Left ventricular mass of all athletes were higher as compared with controls (p &lt; 0.001). Relative wall thickness was not increased in football players but was higher in basketball players as compared with controls (p &lt; 0.05). Conclusion Cardiac remodeling in Lithuanian football players resulted in left ventricle eccentric hypertrophy due to the LV dilation, increased LV mass and relatively normal relative wall thickness. However in Lithuanian basketball players we noticed an increase in both relative wall thickness and LV mass resulting in LV concentric hypertrophy. Echocardiographic characteristics Groups n End-diastolic LV diameter(mm) End-diastolic Interventricular septum (mm) End-diastolic LV posterior wall LV mass Football Players 15 56.9 10.8 10.8 242 Basketball players 15 53.6 11.5 11.3 254 Inactive individuals 20 53.2 9.1 9.5 182 P value 0.01 &lt;0.001 &lt;0.001 &lt;0.01 Abstract P955 Figure.

scholarly journals Structural and functional changes of the heart in patients with diabetic nephropathy undergoing hemodialysis

2019 ◽  
pp. 39-48
Author(s):  
O. B. Susla ◽  
Z. I. Litovkina ◽  
O. V. Bushtynska
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Cardiac Remodeling ◽  
Systolic Dysfunction ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Valve Calcification ◽  
Adequate Treatment ◽  
Functional Changes

Systematic analysis of cardiac remodeling peculiarities in patients with V D stage of chronic kidney disease (CKD VD)  caused by diabetes mellitus is important both in the stratification of cardiovascular risk and in the choice of adequate treatment strategies. The purpose of the study was to determine the character of structural and functional reconstruction of myocardium in patients with diabetic nephropathy (DN) on maintenance hemodialysis (HD) by identifying left ventricular hypertrophy (LVH), its geometric types, assessment of the severity of heart dysfunction, pulmonary hypertension (PH), as well as determination of frequency of cardiac valve calcification (CVC), development of defects of mitral (MV) and aortic (AV) valves. Materials and methods. The study included 136 patients on chronic HD (men, 78, age, (53,9±1,0) years, duration of HD, (47,6±4,2) months). Depending on the presence/absence of type 2 diabetes mellitus (DM) with kidney damage, they were divided into two groups: the first one – without DN (n=88); the second one – with DN (n=48). All patients were followed up by standard echocardiography (EchoCG) examination by standard procedure. Results. LVH was diagnosed in 84.6% of patients with CKD VD stage, significantly more often (93.8 vs. 78.4%, p=0.020) in patients with DN, with the incidence of eccentric LVH in the second group being higher (47.9 vs. 28.4%, p=0.023) than in the first one. Prevalence of pseudonormal and restrictive types of LV diastolic dysfunction (62.5 vs. 28.4%, p<0.001), LV systolic dysfunction (27.1 vs. 9.1%, p=0.006) and PH (64.6 vs 35.2%, p=0.001) were significant in HD patients with DN. CVC was detected in 66.6% of patients with type 2 DM with renal injury with a predominance of calcification of both valves (35.4%) over isolated calcification of MV (MVC) (20.8%) and AV (AVC) (10.4 %). Combined valve calcification in the HD patients of the second group was observed 2.6 times more often (p=0.003) than in the first one. Patients with DN, unlike those without diabetes, were associated with a higher prevalence of stenoses of MV (16.7 vs. 3.4%, p=0.007) and AV (39.6 vs. 15.9%, p=0.004), and insufficiency of MV (66.7 vs. 44.3%, p=0.013) and AV (35.4 vs. 14.8%, p=0.006). The most significant EchoCG parameters that distinguished groups of HD patients with the presence of DN were: left atrial diameter (p<0.001), end-diastolic LV dimension (p<0.001), thickness of interventricular septum (p=0.001), LV myocardial mass index (p=0.001), ratio of transmitral flows in early and late diastole (p=0.009), time of deceleration of early diastolic transmitral blood flow (p<0.001), LV ejection fraction (p=0.009), diameter of the right ventricle (RV) (p=0.003), diameter (p=0.007) and mean pulmonary artery pressure (p<0.001). Conclusions. In patients with CKD VD stage with DN the maladaptive cardiac remodeling with predominance of unfavorable types (eccentric (to a greater extent) and concentric) LV hypertrophy, RV dilatation, PH, expressive of LV diastolic and systolic dysfunction, large-scale combined MVC and AVC occurs, which, in turn, leads to the formation of valve defects, can contribute to the progression of diastolic myocardial stiffness and heart failure.

Fetal Cardiac Remodeling in Response to Anemia: Using Hemoglobin Bart’s Disease as a Study Model

2018 ◽  
Vol 41 (02) ◽  
pp. 186-191 ◽  
Author(s):  
Theera Tongsong ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
At Risk ◽  
Wall Thickness ◽  
Gestational Age ◽  
Cardiac Remodeling ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Width Ratio ◽  
Ventricular Wall ◽  
Ventricular Wall Thickness ◽  
Hb Bart's

Abstract Objective To assess fetal cardiac remodeling in response to anemia, by comparing the fetal cardiac dimensions and global sphericity index (GSI) of normal fetuses and fetuses with anemia using fetal Hb Bart’s disease as a study model. Methods Fetuses at risk for Hb Bart’s disease undergoing cordocentesis at 18 to 22 weeks of gestation were recruited. Fetal cardiac dimensions including GSI (cardiac length to cardiac width ratio), interventricular septum thickness (IVST), left ventricular wall thickness (LVWT) and right ventricular wall thickness (RVWT) were measured. Results 215 pregnancies at risk met the inclusion criteria, including 54 affected fetuses and 161 normal fetuses. The mean GSI was significantly lower in the affected group (1.11 ± 0.06 vs. 1.26 ± 0.09, p-value 0.017). The GSI of the normal group was relatively constant regardless of gestational age. The IVST and LVWT tended to increase, but not significantly, in the affected group, whereas the RVWT was minimally but significantly increased. The ROC curve for GSI had an area under curve of 0.844. The best cut-off of GSI was 1.17, giving a sensitivity of 74.1 % and a specificity of 88.2 %. Conclusion Fetal cardiac remodeling in response to anemia causes a marked decrease in global GSI with minimal hypertrophy as an adaption to volume overload. Importantly, GSI is a new maker for anemia and may play a role in clinical application for early detection of fetal anemia, possibly due to any cause. Additionally, GSI measurement is simple and gestational age-independent.

scholarly journals Left ventricular remodeling in rugby is a physiological adaptation to exercise: a pilot study conducted with high-level athletes

2021 ◽  
Author(s):  
Nuno Dias Rato ◽  
Joanna Richards
Keyword(s):  
Body Composition ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
The Body ◽  
Fat Free Mass ◽  
Physiological Adaptation ◽  
Composition Analysis ◽  
Internal Diameter ◽  
High Level ◽  
Rugby Players

Abstract Purpose Literature examining left ventricular (LV) structural adaptations to combined strength and endurance training is inconsistent. Rugby is a sport that combines these two exercise modalities, both during training and match play. This study aimed to explore differences in LV structure between high-level rugby players and untrained controls. Body composition analysis was performed to determine the most appropriate indexing variable for LV mass (LVM) and understand if increases in LV represent either a training-related physiological adaptation or reflect the groups’ anthropometric differences. Methods A cross-sectional design compared 10 rugby players and 10 untrained age-matched, male controls. Body composition was obtained by bioelectrical impedance. M-mode echocardiographic imaging was performed on the LV from the parasternal long axis view. Results Significantly greater end-diastolic interventricular septum, LV internal diameter, posterior wall thickness, LVM and LVM/fat-free mass (FFM) (p < 0.05) were found in rugby players compared to age-matched controls. Moreover, Pearson’s correlation tests revealed FFM to be the body composition variable with the strongest correlation to LVM (r = 0.775, p < 0.001). Conclusion The differences in LV structure between groups suggest that the combined endurance and strength training that rugby athletes are subjected to, induce a process of concentric and eccentric enlargement of the LV structure. Furthermore, the association found with FFM, suggests it to be the most appropriate body scaling variable to index to LVM and, thus, should be considered when describing increases in LVM. The present research suggests that increased LVM in the athletes group represents true physiological adaptations to training.

Effects of sedation with dexmedetomidine and buprenorphine on echocardiographic variables, blood pressure and heart rate in healthy cats

2017 ◽  
Vol 20 (6) ◽  
pp. 554-562 ◽  
Author(s):  
Einar Johard ◽  
Anna Tidholm ◽  
Ingrid Ljungvall ◽  
Jens Häggström ◽  
Katja Höglund
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Interventricular Septum ◽  
Maximum Velocity ◽  
Left Ventricular ◽  
Aortic Diameter ◽  
Internal Diameter ◽  
Arterial Blood ◽  
Sedative Agents ◽  
Deceleration Time

Objectives Sedative agents are occasionally used to enable echocardiographic examination when screening cats for heart disease, such as hypertrophic cardiomyopathy (HCM). Owing to their haemodynamic effects, sedative agents may alter echocardiographic measurements. The aim of the study was to evaluate the effects of the sedative combination dexmedetomidine and buprenorphine on echocardiographic variables, blood pressure (BP) and heart rate (HR) in healthy cats. Methods Fifty healthy, client-owned cats were prospectively recruited and included after physical examination. Cats were sedated intramuscularly with dexmedetomidine and buprenorphine, according to body weight. Blood pressure and HR measurements, echocardiographic and Doppler examinations were performed prior to sedation and repeated once cats had achieved acceptable sedation. Results Left ventricular internal diameter at end-diastole and systole, right ventricular internal diameter at end-diastole, left atrium (LA), pulmonary artery (PA) deceleration time, and systolic, diastolic and mean arterial blood pressure increased after sedation ( P ⩽0.022). Aortic and PA maximum velocity, fractional shortening, PA acceleration/deceleration time and HR decreased after sedation ( P <0.0001). Interventricular septum at end-diastole and systole, left ventricular posterior wall at end-diastole and systole, aortic diameter (Ao), left atrial/aortic diameter (LA/Ao) and pulmonic acceleration time did not change. Conclusions and relevance Blood pressure increased and HR decreased post-sedation. While wall thickness and LA/Ao were not affected by sedation, indices of LA and left ventricular size increased. Further studies are needed using cats with HCM to assess the effect of this sedative combination on HCM screening results.

scholarly journals Obesity and left ventricular mass in children

2015 ◽  
Vol 55 (4) ◽  
pp. 224
Author(s):  
Mauliza Mauliza ◽  
Muhammad Ali ◽  
Melda Deliana ◽  
Tina Christina L Tobing
Keyword(s):  
Left Ventricular Mass ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Normal Weight ◽  
Obese Group ◽  
Internal Diameter ◽  
Weight Group ◽  
Normal Weight Group ◽  
Ventricular Mass ◽  
Moderate Positive Correlation

Background Obesity has negative effects on cardiac function during growth leading to increased heart size and mass, as a result of higher stroke volume and cardiac output.Objective To assess for a relationship between obesity and left ventricular mass (LVM) in children, as well as to assess for a correlation between the duration of obesity and LVM.Methods This cross-sectional study was conducted from October 2011 until February 2012 in Medan and included 30 obese and 30 normal weight children, aged 6 to 13 years. All subjects underwent complete echocardiography examinations to assess LVM and other left ventricular parameters. The Devereux formula was used to measure LVM.Results During the study, 65 children underwent echocardiography, but 5 were subsequently excluded. The left ventricular dimensions in the obese group were significantly higher compared to normal weight group with regards to interventricular septum at end diastole (IVSd), interventricular septum at end systole (IVSS), left ventricular internal diameter at end diastole (LVIDd), left ventricular internal diameter at end systole (LVIDs), left ventricular posterior wall thickness at end diastole (LVPWd), left ventricular mass (LVM), and left ventricular mass index (LVMI) (P=0.0001). Duration of obesity and LVM had a moderate, positive correlation (r=0.407).Conclusion There is significantly higher LVM in the obese group than in the normal weight group. The duration of obesity had a moderate, positive correlation to LVM.

scholarly journals Detection of Cardiac Remolding After Surgical Closure of Ventricular Septal Defect in Children Less Than One Year

2019 ◽  
pp. 1-4
Author(s):  
Manal Mohamed Helmy Nabo ◽  
Keyword(s):  
Ventricular Septal Defect ◽  
Ejection Fraction ◽  
Cardiac Remodeling ◽  
Septal Defect ◽  
Left Ventricular ◽  
Internal Diameter ◽  
Surgical Closure ◽  
Group A ◽  
Group B ◽  
Fractional Shortening

Background: Cardiac remodeling is an important issue after surgical closure of ventricular septal defect (VSD). Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter in diastole (LVIDd) and left ventricular internal diameter in systole (LVIDs) after surgical closure of VSD defect in patients less than 1 year. Methodology: This study was conducted in the department of pediatric cardiology, Maternity and Children Hospital (MCH), El Madina El Menwara, Saudi Arebia. Patients were divided into 3 groups according to the age. All patients presented with isolated perimembreanous VSD (PM-VSD) who were surgically treated at the age less than1 year. This study population was divided into 3 groups as group A from (0- 3) months, group B from (3- 6) months and group C from 6 months to 1 year. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd and LVIDs were taken pre operative and one month post operative in all groups. The echocardiography was repeated three months post operative in group B and group C. Result: A total number of 100 patients were recruited for this study. All the above parameters were normal 1 month after VSD closure in group group A. However, in both group B and group C the follow up echocardiography was indicated. In both groups the time was needed to reach the normal vlues. Conclusion: Cardiac remodeling is an important indicator of the ability of the cardiomyocyte to be changed to the normal shape and dimension. There are many factors that affect the cardiac cell. The presence of preload or afterload causes can result in delay of remodeling. As long as the patient start to take medication for anti failure cause, the suspicion of remodeling will be delayed

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