Cases Of Left Ventricular Hypertrophy Research Articles

Cholecalciferol, serum calcium and left ventricular hypertrophy in essential hypertension.

Objective: To assess the correlation of vitamin cholecalciferol and serum calcium with left ventricular hypertrophy (LVH) in essential hypertension patients presenting at a tertiary care hospital. Study Design: Cross Sectional Comparative study. Setting: Department of Cardiology and Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh. Period: July 2019 to January 2021. Material & Methods: 100 diagnosed LVH+ Essential Hypertenison cases and 100 diagnosed essential hypertension (controls) were selected through non- probability purposive sampling. Echocardiography, serum cholecalciferol, calcium, phosphate, parathyroid hormone (PTH), alkaline phosphatase (ALP), urea and creatinine were measured form sera. Devereux’s formula measured the LV thickness LVH. SPSS ver. 21.0 analyzed the descriptive statistics and compared the variables at 95% Confidence interval (P≤0.05). Results: Serum calcium, phosphate and parathyroid hormone were found elevated in LVH cases compared to control (P=0.0001). Cholecalciferol in LVH cases was low noted as 27.3±7.84 ng/dl compared to 39.5±0.43 ng/dl in controls (P=0.0001). Cholecalciferol in mild, moderate and severe LVH cases was descending order as 30.67±7.84, 24.76±7.72 and 14.96±6.12 mm respectively (P-0.0001). Serum cholecalciferol proves inverse association (r= -0.180) with LVH (p=0.003). Conclusion: The present study reports vitamin cholecalciferol deficiency increases the chances of left ventricular hypertrophy through increased secretion of parathyroid hormone that induces de – novo protein synthesis of ventricular myocardium.

Study of the Electrocardiographic Profile in Judokas

Introduction:Depending on the number of hours, load and type of physical exercise, the heart of an athlete undergoes changes throughout the sports practice, since it has an increase in its work to meet the metabolic needs. These changes may result in a condition known as "athlete's heart," where physiological cardiovascular changes are seen during exercise. Some of these changes can be observed at the electrocardiographic level, and can be differentiated between pathological and non-pathological changes, according to the criteria defined for athletes, and the Seattle criteria were used in this study. Objective: It was intended to analyze the electrocardiographic profile in judokas, to observe if these athletes have or not ECG alterations, and if these alterations are physiological or pathological. It was also verified the relationship between training load and electrocardiographic alterations, and relationship between training load and ECG results. Methodology: Questionnaires and 12-lead electrocardiograms at rest were performed in a group of 20 judokas who practice judo for 1 year or more and age between 15 and 25 years. Main results: It was found that of the 20 judokas evaluated, all had sinus rhythm, 1 case with right axis deviation, 2 cases with sinus bradycardia, 1 case with sinus tachycardia, 1 case of left ventricular hypertrophy, and the remaining variables were unchanged in the ECG. Conclusion: Although a small sample was analyzed, it was found that changes in ECGs were found, but they are not statistically significant, and also are not pathological for athletes, according to the Seattle criteria.

Cardiac structure and function in resistant hypertension: The beneficial role of blood pressure control.

Cardiac structure and function in resistant hypertension: The beneficial role of blood pressure control.

Left ventricular hypertrophy detection using electrocardiographic signal

Left ventricular hypertrophy (LVH) indicates subclinical organ damage, associating with the incidence of cardiovascular diseases. From the medical perspective, electrocardiogram (ECG) is a low-cost, non-invasive, and easily reproducible tool that is often used as a preliminary diagnosis for the detection of heart disease. Nowadays, there are many criteria for assessing LVH by ECG. These criteria usually include that voltage combination of RS peaks in multi-lead ECG must be greater than one or more thresholds for diagnosis. We developed a system for detecting LVH using ECG signals by two steps: firstly, the R-peak and S-valley amplitudes of the 12-lead ECG were extracted to automatically obtain a total of 24 features and ECG beats of each case (LVH or non-LVH) were segmented; secondly, a back propagation neural network (BPN) was trained using a dataset with these features. Echocardiography (ECHO) was used as the gold standard for diagnosing LVH. The number of LVH cases (of a Taiwanese population) identified was 173. As each ECG sequence generally included 8 to 13 cycles (heartbeats) due to differences in heart rate, etc., we identified 1466 ECG cycles of LVH patients after beat segmentation. Results showed that our BPN model for detecting LVH reached the testing accuracy, precision, sensitivity, and specificity of 0.961, 0.958, 0.966 and 0.956, respectively. Detection performances of our BPN model, on the whole, outperform 7 methods using ECG criteria and many ECG-based artificial intelligence (AI) models reported previously for detecting LVH.

Serum Uric acid in essential hypertension and its correlation with left ventricular hypertrophy.

Objective: To estimate serum uric acid in essential hypertension and its correlation with left ventricular hypertrophy (LVH) in patients presenting at a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of Cardiology and Medicine, BMC Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad and NICVD Hyderabad, Sindh. Period: July 2018 to January 2021. Material & Methods: A sample of 100 diagnosed cases of essential hypertenison (group A), 100 essential hypertenison with LVH cases (group B) and 100 age matched healthy control (group C) was selected through non- probability convenient sampling. Echocardiography findings of cases and control were noted. Serum uric acid, urea and creatinine were measured form sera. LVH was defined by Devereux’s formula. Continuous variables were analyzed Student`s Independent samples t – test and Pearson`s correlation was used for essential hypertension and LVH on SPSS ver. 21.0 at 95% Confidence interval (P≤0.05). Results: Serum uric acid in EH, EH+LVH and controls was noted as 5.5±1.0, 5.8±1.9 and 3.81±1.2 mg/dl (P-0.0001). LV in EH, EH+LVH and controls was measured as 10.8±2.3, 16.4±3.3 and 9.6±0.2 mm in 3 study groups (P-0.0001). Uric acid proves statistically significant linear correlation in EH+LVH revealing positive correlation (r=0.475), (P=0.0001). Conclusion: The present study reports serum Uric acid is found elevated in essential hypertension and essential hypertension with left ventricular hypertrophy. Uric acid shows positive correlation with left ventricular hypertrophy.

The Correlation Between ABPM Parameters and Left Ventricular Hypertrophy in Pediatric Essential Hypertension.

ObjectiveTo explore the association of dipping pattern and blood pressure load with left ventricular hypertrophy (LVH) in pediatric essential hypertension.Materials and MethodsThrough an echocardiography monitor and an ambulatory blood pressure monitor of 425 children and adolescents diagnosed with essential hypertension with no treatment received, we identified 140 cases of LVH. Grouping patients according to LVH (LVH, N = 140; n-LVH, N = 285), we further evaluated their ambulatory blood pressure monitoring (ABPM) parameters by comparing dipping patterns between groups. A multivariable logistic regression analysis was used to determine the effect of blood pressure load on LVH.ResultsNo significant difference was found in systolic or diastolic blood pressure dipping patterns between groups (P = 0.161, P = 0.139). However, compared to the n-LVH group, the LVH group presented significant elevated nighttime systolic blood pressure (SBP) (P < 0.05), while nighttime DBP remained stable (P = 0.391), resulting in higher daytime and nighttime SBP loads, higher nighttime DBP load, and higher 24-h SBP load (P < 0.05). Notably, our multivariable logistic regression has shown that this trend of 24-h SBP load acts independently as a critical risk factor for LVH.ConclusionCollectively, we observed a correlation between BP load and LVH in pediatric hypertension. Our data demonstrated that SBP load has a more significant weight in LVH progression, and 24-h SBP load, in particular, acts as a critical early prognostic parameter for LVH in pediatric hypertension.

Electrocardiogram (ECG) Diagnosis of Left Ventricular Hypertrophy and its Associations in Patients Living with Diabetes.

Macrovascular complications of diabetes mellitus (DM) include cardiac manifestations such as left ventricular hypertrophy (LVH), which can increase the risk of heart failure and death. To determine associations between LVH and other variables in patients living with DM (PLWD). A retrospective study over 1 year was conducted on patients who attended the DM clinic at Edendale Hospital in South Africa. Electrocardiographs (ECGs) and standardised data sheets were analysed. The Sokolov-Lyon, Cornell and Romhilt-Estes methods were utilised for diagnosing LVH on ECGs. There were 609 PLWD included in the study, with 80 PLWD (13.1%) having LVH (LVH+), whereas 529 PLWD (86.9%) had no LVH (LVH-). The Sokolov-Lyon method proved to be the best method of diagnosing LVH based on ECG (100% of patients diagnosed), with an 'R wave in Augmented Vector Left (AVL) ≥11 mm' being the best approach for determining LVH. LVH + patients were significantly younger than LVH - patients (27.22 years vs. 58.98 years, P < 0.001) and had lower systolic blood pressure (SBP) (118.62 mmHg vs. 139.77 mmHg, P < 0.001). Type 1 DM (DM1+) comprised the majority (77.5%) of LVH + patients. LVH + patients had significantly better high-density lipoproteins (1.36 mmol/L vs. 1.25 mmol/L, P = 0.024) and triglycerides (1.40 mmol/L vs. 1.85 mmol/L, P = 0.010) than LVH - patients. LVH was seen more frequently in younger patients who often had DM1+, lower SBP, higher HDL, and lower triglycerides. Most cases of LVH were diagnosed using the Sokolov-Lyon method. LVH should be screened for frequently in PLWD, irrespective of whether patients are hypertensive or not, and this should be done at all ages.

Abstract 12100: Exploration of Proteomic Risk Markers for Incident Heart Failure and Cardiac Remodeling in Three European Population-Based Cohorts

Introduction: Several biomarkers have been linked with incident heart failure (HF), but the pathophysiology of HF is complex and multifactorial. Hypothesis: We explored 92 biomarkers’ associations with left ventricular hypertrophy (LVH), prevalent LV diastolic dysfunction (LVDD), and incident HF in three European population-based cohorts. Methods: Profiling of 92 biomarkers was carried out in 1737 participants from the echocardiography subsample of the population-based cohort study, the Malmö Preventive Project (mean age 67 years, 29% women). The final study sample consisted of 1681 subjects for analyses of incident HF (n=130), and 1530 subjects for analyses of LVDD (n=109) and LVH (n=498). Multivariable Cox regression analyses excluding subjects with prevalent HF were carried out for incident HF. Multivariable logistic regression analyses excluding subjects with reduced or mid-range LV ejection fraction (&lt;50%) were carried out for LVDD and LVH. Replication analyses of significant findings were carried out in the HOMAGE (562 cases of incident HF, 871 controls) and STANISLAS cohorts (304 cases of LVDD and 1668 controls; and 245 cases of LVH and 1681 controls). Results: In the multivariable model adjusted for clinical risk factors, six proteins were associated with incident HF (median follow-up time 12.6, interquartile range 10.9-13.6 years): ST2 (hazard ratio (HR) 1.40; 95% confidence interval (1.03-1.91); p=0.031), GDF-15 (HR 1.33 (1.00-1.77); p=0.048), AZU1 (HR 1.42 (1.10-1.82); p=0.006), MPO (HR 1.48 (1.02-2.15); p=0.041), Gal-4 (HR 1.37 (1.02-1.85); p=0.038) and NT-proBNP (HR 1.98 (1.66-2.36); p=2.1x10 -14 ) in the discovery cohort. In the replication cohort, ST2, GDF15, NT-proBNP and Gal-4 also displayed significant associations with incident HF. In analyses of DD, none of the associated proteins in the discovery cohort (AZU1; TR; PCSK9 and NT-proBNP) were replicated in the STANISLAS cohort. Among AZU1, PGLYRP1, and NT-proBNP, NT-proBNP was the only protein that was significantly associated with LVH in both cohorts. Conclusions: We replicated the association of ST2, GDF-15, NT-proBNP and Gal-4 with incident HF, whereas NT-proBNP was the only biomarker that was associated with LVH as well as incident HF in discovery and replication cohorts.

A closed audit reviewing the electrocardiograms of patients presenting to the memory assessment team

AimsTo review the ECGs of all patients referred to MAT services over the preceding 5 year period.BackgroundNeurodegenerative conditions such as Alzheimer's Disease can be treated with Acetylcholinesterase Inhibitors (AChEI) to slow down cognitive decline. Side effects of AChEIs include bradycardia, syncope and cardiac conduction disorders. An electrocardiograms (ECG) is completed prior to memory assessment team (MAT) medical assessments to screen for those who may be at risk of the cardiac side effects of AChEIs. ECGs may be included in the initial referral to the service or completed by the MAT. Given the predominantly elderly population referred to the MATs service, other incidental abnormalities are to be expected. Not all MAT referrals that are screened by memory nurses reach the threshold to be reviewed by the medical team and therefore not all ECGs are routinely reviewed, potentially missing clinically significant abnormalities.ResultA total of 1795 patients were identified as being referred to a single mental health unit in the North West on England over a five-year period. 781 (44%) of the patients had an ECG completed by the MAT, of which 452 (58%) showed an abnormality. Significant abnormalities that were previously unknown to the patients’ primary care provider include eight cases of Atrial Fibrillation (AF), four cases of Trifasciular Block, and 19 cases of Left Ventricular Hypertrophy (LVH). 64 (8%) of patients who had an ECG by the MAT had a bradycardia.ConclusionIn addition to identifying abnormalities that could interfere with memory medication, this audit showed that over half of the ECGs completed by the MAT had an atypical trace. Cardiology was consulted to identify which abnormalities were considered clinically significant and if not already known, the general practitioner (GP) was informed. A change in the local service means that all ECGs completed by the MAT are now screened at point of filling into the notes, so any future abnormalities are identified and followed up immediately.

Association between insulin resistance and left ventricular hypertrophy in asymptomatic, Black, sub-Saharan African, hypertensive patients: a case\u2013control study

BackgroundConflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH). We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension.MethodsA case–control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables.ResultsEighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by threefold [aOR 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by eightfold [aOR 8.4; 95 (3.7–15.7); p < 0.001].ConclusionObesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.

Correlations of circulating miR-26b level with left ventricular hypertrophy and cardiac function in elderly patients with hypertension.

Objectives:To study the correlations of circulating miR-26b level with left ventricular hypertrophy (LVH) and cardiac function in elderly patients with hypertension.Methods:A total of 132 eligible patients were divided into low and high miR-26b level groups. Their baseline clinical data and biochemical indices were compared. The correlations between miR-26b level and echocardiographic parameters were studied by Pearson’s analysis. Factors affecting LVH were explored by multivariate logistic regression analysis. The role of miR-26b in diagnosing LVH was predicted by receiver operating characteristic curve.Results:The relative expression level of miR-26b was 4.56-16.93, with a median of 7.62. The two groups had similar baseline clinical data and biochemical indices (P>0.05). Compared with high miR-26b level group, interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI) and number of LVH cases in low miR-26b level group significantly increased (P<0.05), and mitral ratio of peak early to late diastolic filling velocity (E/A) decreased (P<0.05). Circulating miR-26b level was negatively correlated with IVST, LVPWT and LVMI (P<0.0001), and positively correlated with E/A (P<0.0001). The proportion of cardiac hypofunction cases in low miR-26b level group significantly exceeded that of high miR-26b level group (P<0.05). Age and increased IVST, LVPWT and LVMI were independent risk factors for LVH (P<0.05), and elevated miR-26b level was a protective factor (P<0.05). AUC was 0.836, and the optimal cutoff value was 8.83, with high sensitivity and specificity.Conclusions:MiR-26b level is negatively correlated with LVH and positively correlated with left ventricular diastolic function in elderly hypertensive patients. It is a protective factor for LVH complicated with diastolic dysfunction and a potential biomarker for diagnosis.

Heat map visualization for electrocardiogram data analysis

BackgroundMost electrocardiogram (ECG) studies still take advantage of traditional statistical functions, and the results are mostly presented in tables, histograms, and curves. Few papers display ECG data by visual means. The aim of this study was to analyze and show data for electrocardiographic left ventricular hypertrophy (LVH) with ST-segment elevation (STE) by a heat map in order to explore the feasibility and clinical value of heat mapping for ECG data visualization.MethodsWe sequentially collected the electrocardiograms of inpatients in the First Affiliated Hospital of Shantou University Medical College from July 2015 to December 2015 in order to screen cases of LVH with STE. HemI 1.0 software was used to draw heat maps to display the STE of each lead of each collected ECG. Cluster analysis was carried out based on the heat map and the results were drawn as tree maps (pedigree maps) in the heat map.ResultsIn total, 60 cases of electrocardiographic LVH with STE were screened and analyzed. STE leads were mainly in the V1, V2 and V3 leads. The ST-segment shifts of each lead of each collected ECG could be conveniently visualized in the heat map. According to cluster analysis in the heat map, STE leads were clustered into two categories, comprising of the right precordial leads (V1, V2, V3) and others (V4, V5, V6, I, II, III, aVF, aVL, aVR). Moreover, the STE amplitude in 40% (24 out of 60) of cases reached the threshold specified in the STEMI guideline. These cases also could be fully displayed and visualized in the heat map. Cluster analysis in the heat map showed that the III, aVF and aVR leads could be clustered together, the V1, V2, V3 and V4 leads could be clustered together, and the V5, V6, I and aVL leads could be clustered together.ConclusionHeat maps and cluster analysis can be used to fully display every lead of each electrocardiogram and provide relatively comprehensive information.

Telemetric electrocardiographic diagnostics of myocardial pathology in persons of working age

Remote electrocardiographic techniques were used in outpatient departments of the city clinical hospital (CCH) and the Central district hospital (CDH). The CDH performed 18,654 electrocardiographic studies (ECS). The automatic conclusion of devices was corrected by specialists of functional diagnostics (FD). In complex cases, an in — depth analysis was performed- an electrocardiogram of 12 leads (ECD -12) — using vectorcardiography (VCD). Pathological ECD syndromes were detected in 5038 individuals (27%). Among the obtained number of ECSs with abnormalities, the most frequently detected were: right leg block ( RLB) — 1029 (20.4%), left ventricular hypertrophy (LVH) — 981 (19.4%), left leg block — 661 (13%), myocardial scarring — 442 (8.7%), extrasystole — 377 (7.4%), atrial fibrillation-310 (6%). The method of VCD was able to clarify 39% of cases of LVH, 40% of cases of focal scarring of the myocardium, and 92% of matches for atrial fibrillation (AF). The use of VCD supplemented the diagnostic capabilities of the remote ECD-12. According to the results of AF screening by remote single-channel ECD, 69 cases with AF (3.2%) of the total number of examined patients (2,146 people) were detected in the CCH. When analyzing the history, it was clarified that 24 (34.7%) patients had AF for the first time, and 45 (65.3%) individuals had a history of AF. Remote long-term Holter ECD monitoring system (LTHECD) 27 studies were performed in 20 individuals. Complex, combined heart rhythm disorders were detected in 85%, and ST-T depression was detected in three cases (15%). Using new electrocardiographic techniques in addition to single-channel ECD, ECD-12 improves the quality of diagnostics of cardiovascular diseases (CVD).

Abstract P345: Left Ventricular Hypertrophy Screening via Machine Learning for Young Adults

Background: A use of conventional 12-lead electrocardiographic (ECG) criteria and machine learning for the ECG parameters to identify the presence of left ventricular hypertrophy (LVH) is estimated 20%-30% in the general population. We developed an ECG system with simple anthropometric data using machine learning to increase the sensitivity in screening for LVH. Methods: In a large sample of 2,196 males, aged 17-45 years, the support vector machine (SVM) classifier with linear kernel is used as the machine learning method for 31 characteristics including age, body height, and body weight in addition to 28 ECG parameters such as axes, intervals and voltages to link the output of LVH. The diagnosis of LVH is based on the echocardiographic criteria for young adult males as 116 g/m 2 (left ventricular mass (LVM)/body surface area) or 49 g/m 2.7 (LVM/body height 2.7 ). The samples are divided into a training/validation set and a test set. By applying the synthetic minority over-sampling technique (SMOTE) in pre-processing of training data, the imbalance in sample size between the Non-LVH and LVH cases can be solved. Results: For the test set with 440 cases, average accuracy, specificity, sensitivity, precision and F 1 score are 76.1%, 75.1%, 92.6%, 19.5% and 32.3%, respectively. The AUCs of ROC and PR curves are 0.871 and 0.272, respectively. To compare with the Cornell and Sokolow-Lyon voltage criteria as shown in Fig.1, all data of the 2,196 young males are also tested in the model. With the specificity of 73.3%, our SVM technique provides much better sensitivity 86.7% compared to 3.3% and 52.7% for the Cornell and Sokolow-Lyon voltage criteria, respectively. The body height and body weight are the most important factors among the 31 features in our SVM model. Conclusions: We provide a novel screening tool using simple anthropometrics and several ECG data to identify LVH in young adults and improves much in sensitivity as compared with the conventional ECG criteria or using machine learning for ECG data alone to identify LVH.

Tenascin- C: A Promising Marker in Identifying Patients with Cardiovascular and Pulmonary Remodeling

Objectives: Our aim was to study serum levels of tenascin-C (TnC ) in patients with pulmonary hypertension and left ventricular hypertrophy in order to explore its diagnostic utility for cardiac remodeling among elderly patients admitted at Ain Shams University hospitals, Egypt. Methods: A case control study was conducted on 279 elderly selected from Ain Shams University Hospital. They were classified into 3groups; (Group I): 105 cases suffering from pulmonary hypertension (PH), (Group II):114 cases suffering from systemic hypertension and (Group III): 60 apparently healthy subjects serving as control group. Group I was classified according to WHO classification into 4 classes. Group I was reclassified according to the disease severity into 2 subgroups. Group II was reclassified into 2 subgroups according to presence or absence of concomitant left ventricular hypertrophy (LVH). All subjects were subjected to history taking, clinical examination, echocardiograhic measurements (for cases only), TnC assay by enzyme linked immunosorbent assay (ELISA) and lipid profile. Results: Serum tenascin-C showed a highly significant elevation in PH and LVH cases than controls (p<0.001). In addition, (ROC) curve analysis revealed a superior performance of TnC in discrimination of PH cases from healthy controls at cut-off value of 0.3ng/mL with sensitivity (91.4%), specificity (100%). Moreover, the diagnostic performance of TnC in discriminating PH patient’s subgroups was best at cut-off value of 4.3ng/mL with sensitivity (89.3%), specificity (85.7%).Conclusion: Serum TnC is a promising diagnostic marker for identifying patients with tissue remodeling in PH and LVH.

Genetic variants predicting left ventricular hypertrophy in a diabetic population: a Go-DARTS study including meta-analysis

BackgroundLeft ventricular hypertrophy has multiple aetiologies including diabetes and genetic factors. We aimed to identify genetic variants predicting left ventricular hypertrophy in diabetic individuals.MethodsDemographic, echocardiographic, prescribing, morbidity, mortality and genotyping databases connected with the Genetics of Diabetes Audit and Research in Tayside, Scotland project were accurately linked using a patient-specific identifier. Left ventricular hypertrophy cases were identified using echocardiographic data.Genotyping data from 973 cases and 1443 non-left ventricular hypertrophy controls were analysed, investigating whether single nucleotide polymorphisms associated with left ventricular hypertrophy in previous Genome Wide Association Studies predicted left ventricular hypertrophy in our population of individuals with type 2 diabetes. Meta-analysis assessed overall significance of these single nucleotide polymorphisms, which were also used to create gene scores. Logistic regression assessed whether these scores predicted left ventricular hypertrophy.ResultsTwo single nucleotide polymorphisms previously associated with left ventricular hypertrophy were significant: rs17132261: OR 2.03, 95% CI 1.10-3.73, p-value 0.02 and rs2292462: OR 0.82, 95% CI 0.73-0.93 and p-value 2.26x10-3. Meta-analysis confirmed rs17132261 and rs2292462 were associated with left ventricular hypertrophy (p=1.03x10-8 and p=5.86x10-10 respectively) and one single nucleotide polymorphisms in IGF1R (rs4966014) became genome wide significant upon meta-analysis although was not significant in our study. Gene scoring based on published single nucleotide polymorphisms also predicted left ventricular hypertrophy in our study.Rs17132261, within SLC25A46, encodes a mitochondrial phosphate transporter, implying abnormal myocardial energetics contribute to left ventricular hypertrophy development. Rs2292462 lies within the obesity-implicated neuromedin B gene. Rs4966014 lies within the IGF1R1 gene. IGF1 signalling is an established factor in cardiac hypertrophy.ConclusionsWe created a resource to study genetics of left ventricular hypertrophy in diabetes and validated our left ventricular hypertrophy phenotype in replicating single nucleotide polymorphisms identified by previous genome wide association studies investigating left ventricular hypertrophy.

The value of RV(6) > RV(5) of ECG in diagnosis of pneumocardiac disease complicated by left ventricular hypertrophy in coal-workers with pneumoconiosis

This thesis will discuss the value of RV(6) > RV(5) of ECG in diagnosis of pneumocardiac disease complicated by left ventricular hypertrophy in coal-workers with pneumoconiosis through the analysis of the ECG characteristics in the postmortem examination of coal-workers with pneumoconiosis. Three data groups will be formed on the basis of the ECG data in the case 47 postmortem examination of coal-workers with pneumocardiac disease complicated by left ventricular hypertrophy, and they are right deviation group with ECG cardiac electric axis more than 90 degrees (case 16), no deviation group with ECG cardiac electric axis between 30 degrees and 90 degrees (case 16) and left deviation group with ECG cardiac electric axis between 30 degrees and -30 degrees (case 15). The method that this thesis adopted is to compare the thickness of the right and left ventricle walls of the three groups, their ratio and the detectable ratio of ECG RV(6) > RV(5). The detectable rate of the thickness of right ventricle front wall, the thickness of the left ventricle wall, the thickness of the left ventricle wall to the thickness of right ventricle wall and ECG RV(6) > RV(5) in left deviation group is obviously higher than those of the no deviation group and right deviation group. The differences between the three groups are of statistics significance (P < 0.01); the detectable rate of the thickness of right ventricle front wall, the thickness of the left ventricle wall, the thickness of the left ventricle wall to the thickness of right ventricle wall and ECG RV(6) > RV(5) in no deviation group is obviously higher than those of the right deviation group. The differences are of statistics significance (P < 0.01). In case 47 that pneumocardiac disease complicated by left ventricular hypertrophy in coal-workers with pneumoconiosis, the ECG shows 20 cases of ECG RV(6) > RV(5). There are altogether 3 kinds of ECG types: (1) 14 cases of ECG RV(6) > RV(5); (2) 4 cases of left ventricular hypertrophy; (3) 2 cases of right ventricular hypertrophy. The left deviation of ECG cardiac electric axis and ECG RV(6) > RV(5) can be used as indications to diagnosis of pneumocardiac disease complicated by left ventricular hypertrophy in coal-workers with pneumoconiosis.

Left ventricular hypertrophy

Left ventricular hypertrophy

Interpretación computarizada del electrocardiograma para el diagnóstico de hipertrofia del ventrículo izquierdo. Proyecto ELECTROPRES

Introduction Despite its low sensitivity, the electrocardiogram (ECG) is the tool used the most in the daily practice for detection of left ventricular hypertrophy (LVH). This study has aimed to assess the impact of the computerized interpretation of the ECG on the diagnosis of LVH in the practical clinical setting. Methods ELECTROPRES is a project based on a free access computer platform that permits an online interpretation of the electrocardiogram. It includes 19 different left LVH criteria previously validated by echocardiography in a substudy. We analyzed the data from the first 669 patients with essential arterial hypertension (ATH) included in the ELECTROPRES platform from 21 primary care centers in 9 of the 17 Spanish autonomous communities. Results Up to April 2010, a cohort of 669 hypertensive patients (51.7% women), with a mean age of 66.3 ± 11.89 years, was analyzed. The mean evolution of the disease was 8 years, and the patients had been receiving an average of 2.4 antihypertensive agents. Systolic blood pressure was 139 ± 17 mmHg and diastolic blood pressure 76 ± 11. The ECG-known frequency of LVH was 3%. The prevalence of LVH increased up to 33.3% ( P < 0.001) with the ELECTROPRES platform. When all the criteria were independently examined, the Lewis index (R-I + S-III) and the Cornell product [(R-aVL + S-V3 (+6 for women)] were those in which the most cases of left ventricular hypertrophy were detected (24.8% and 13.3%, respectively). The Lewis index and the Cornell product were the criteria that detected more cases of left ventricular hypertrophy, regardless of the AHT stage and of the presence of cardiovascular complications. Conclusions The ECG computerized reading (ELECTROPRES platform) significantly increases detection of left ventricular hypertrophy in a population of essential hypertense subjects compared to conventional detection with the ECG by the physician in the usual clinical practice setting.

Histologically Measured Cardiomyocyte Hypertrophy Correlates with Body Height as Strongly as with Body Mass Index

Cardiac myocytes are presumed to enlarge with left ventricular hypertrophy (LVH). This study correlates histologically measured myocytes with lean and fat body mass. Cases of LVH without coronary heart disease and normal controls came from forensic autopsies. The cross-sectional widths of myocytes in H&E-stained paraffin sections followed log normal distributions almost to perfection in all 104 specimens, with constant coefficient of variation across the full range of ventricular weight, as expected if myocytes of all sizes contribute proportionately to hypertrophy. Myocyte sizes increased with height. By regression analysis, height2.7 as a proxy for lean body mass and body mass index (BMI) as a proxy for fat body mass, exerted equal effects in the multiple correlation with myocyte volume, and the equation rejected race and sex. In summary, myocyte sizes, as indexes of LVH, suggest that lean and fat body mass may contribute equally.