Left Ventricular Mass Index In Group Research Articles

The role of ultrasonic cardiogram in the diagnosis of hypertension complicated with type 2 diabetes mellitus

ABSTRACT Hypertension diabetes mellitus is one of the serious complications of hypertension. In this study, ambulatory blood pressure monitoring (ABPM) and ultrasonic cardiogram (UCG) were used to investigate the cardiac changes and its influencing factors in hypertensive patients with type 2 diabetes mellitus. The ABPM, UCG, Hemoglobin A1c (HbA1c) and body mass index (BMI) of patients were examined. The comparison of HbA1c, BMI, gender, age, daytime and nighttime blood pressure, left ventricular mass index (LVMI), left ventricular hypertrophy (LVH), isovolumic relaxation time (IVRT) and E/A ratio were made between the two groups. The cardiac function of control group was better than that of group B, while that of group B was better than group A. The cardiac index level in group B was better than that in group A, but lower than that in control group. The LVMI in group A was clearly higher than group B and control group, and the incidence of LVH increased. In group A, the nocturnal systolic blood pressure was higher than control group and group B. Nocturnal diastolic blood pressure, daytime diastolic blood pressure and systolic blood pressure in groups A and B were higher than those the control group. The findings indicated that hypertension complicated with type 2 diabetes mellitus can cause degeneration of the heart, and complicated with type 2 diabetes mellitus can accelerate ventricular remodeling and functional deterioration. Hypertension with type 2 diabetes mellitus are more prone to left ventricular damage.

Assessment of left ventricular mass index on left ventricular remodeling and reversion in patients after aortic valve replacement

Objective To evaluate the reverse of the left ventricular remodeling by left ventricular mass index(LVMI) from real-time three-dimensional echocardiography (RT-3DE) in patients after aortic valve replacement (AVR). Methods Sixty-three patients included 36 moderate or severe aortic insufficiency (Group AI) and 27 moderate or severe aortic stenosis (Group AS) who accepted aortic valve replacement and 32 healthy subjects were enrolled. LVMI, left ventricular end-diastolic volume index(LVEDVI), left ventricular end-systolic volume index (LVESVI), and left ventricular ejection fraction (LVEF) were measured and compared with RT-3DE during 1 week pre-, 1 week post-, 1 month post- and 6 months post-operation. Results LVMI in Group AI and Group AS were significantly higher than those in healthy subjects during 1 week pre-, 1 week post-, 1 month post- and 6 months post-operation (all P<0.05). Compared with pre-operation, LVEDVI, LVESVI, LVMI in Group AI and LVMI in Group AS were significantly decreased during 1 week post-operation(all P<0.05). LVMI in Group AI was significantly decreased during 1 month post-operation compared with those during 1 week post-operation(all P<0.05). Negative correlation between LVMI and LVEF in patients group after 1 week, 1 month and 6 month post-AVR (r=-0.69, -0.74, -0.86; P<0.05). Conclusions AVR can reverse left ventricular remodeling in patients with moderate or severe aortic insufficiency or aortic stenosis, which can be quantitatively evaluated by LVMI on RT-3DE. Key words: Echocardiography, real-time three-dimensional; Aortic valve replacement; Left ventricular mass index; Aortic valve insufficiency; Aortic valve stenosis

Changes in left ventricular structure and function in patients with metabolic syndrome

ObjectiveTo determine the changes in left ventricular function and types of ventricular remodelling in patients with metabolic syndrome with hypertension (HMS), metabolic syndrome without hypertension (MS-none) and essential hypertension.MethodsA total...

Modified TEI Index: A Promising Parameter in Essential Hypertension?

Modified TEI index is pointed to be more effective in the evaluation of global cardiac functions compared to systolic and diastolic measurements alone. We planned to determine its applicability in hypertension and relation with left ventricular mass index (LVMI). We studied 48 patients with mild/moderate hypertension and normal coronary angiograms. In total 22 patients (12 men, 10 women, mean age: 55 +/- 6) with normal LVMI were studied in group I, 26 patients (12 men, 14 women, mean age: 57 +/- 7) with increased LVMI in group II, and 20 patients (10 men, 10 women, mean age: 53 +/- 7) with normal blood pressure as a control group. Standard 2D, Doppler, and mitral annulus pulse wave tissue Doppler were used for all measurements. Modified TEI index was calculated as diastolic time interval measured from end of Am wave to origin of Em (a') minus systolic Sm duration (b') divided by b(a'-b'/b'). Modified TEI index was significantly higher in both groups than normal group and in group II than in group I. ( 0.33 +/- 0.05, group I: 0.51 +/- 0.17, group II: 0.68 +/- 0.16, P< 0.0001). Modified TEI index, a marker of left ventricular systolic and diastolic functions, is impaired in hypertensives before hypertrophy develops and impairment is more prominent in hypertrophy. Therefore, (1) modified TEI index in hypertensives is a safe, feasible, and sensitive index for evaluation of global ventricular functions. (2) Evaluation of hypertensives with this index periodically may guide interventions directed toward saving systolic and diastolic functions. (3) Modified TEI index is gaining importance as a complementary parameter to standard Doppler or in cases where standard Doppler has its limitations.

Effect of donor-recipient size mismatch on left ventricular remodeling after pediatric orthotopic heart transplantation

Left ventricular (LV) hypertrophy has been reported after orthotopic heart transplantation. This study was designed to determine the pattern of LV remodeling in the first year after pediatric orthotopic heart transplantation and to elucidate the mechanism responsible for changes in LV dimensions. Serial echocardiograms of 20 children who underwent cardiac transplantation were analyzed off-line, and the following LV parameters were measured and indexed to body surface area (BSA): short-axis diameters, posterior wall thickness, length, mass, and volume in systole and diastole. Mass/ volume and short-axis diameter/length ratios and ejection fraction were calculated. In 5 patients, the donor's echocardiogram was also available for analysis. The patient's systemic blood pressure at the time of the echocardiogram, ischemic time of the donor heart, number of rejection episodes, biopsy scores, and body size of the donor and patient were recorded. Patients were assigned to 2 groups based on their donor-recipient weight ratio: group 1, ≤1.2 (n = 9); and group 2, >1.2 (n = 11). In group 1, LV mass index remained within normal limits throughout the study period. In group 2, mass index was significantly increased 2 weeks after transplantation (72 ± 24 vs 133 ± 37 g/BSA 1.5, p = 0.0008). LV volume, geometry, ejection fraction, systemic blood pressure, and number of rejection episodes did not differ significantly between groups. The excess LV mass index in group 2 regressed significantly during the first year after transplantation from 133 ± 37 to 93 ± 17 g/BSA 1.5 (p < 0.005). Similarly, LV mass/volume ratio decreased from 2.4 ± 0.9 to 1.5 ± 0.4 (p < 0.02). The degree of initial LV hypertrophy in group 2 correlated with the degree of donor-recipient size mismatch (r = 0.86, p < 0.0001). This correlation persisted at 6 months after transplantation (r = 0.72, p = 0.0015), but was not present at 12 months. The initial LV mass in group 2 was significantly smaller when indexed to the donor's BSA (Z score = 2.0 ± 1.8 SD) than when indexed to the recipient's BSA (Z score = 6.9 ± 3.3 SD, p = 0.0008). There was no significant difference between LV mass measured in the donor before transplantation and the mass measured in the recipient 2 weeks after transplantation. These results indicate that increased LV mass found immediately after transplantation can largely be accounted for by donor-recipient size mismatch. In patients with LV hypertrophy, the left ventricle remodels during the first year after transplantation, with regression of excess mass and a decrease in mass/volume ratio toward the normal range.

Does Isovolumic Relaxation Time Reflect the Severity of Left Ventricular Hypertrophy in Patients with Essential Hypertension?

To elucidate whether the isovolumic relaxation time (IRT) reflects the severity of left ventricular hypertrophy, IRT and left ventricular mass index (LVMI) were measured in 43 patients with essential hypertension and in 17 normotensive controls. The hypertensive patients were subdivided into three groups based on interventricular septal thickness (IVST) and left ventricular posterior wall thickness (PWT), determined echocardiographically, and clinical symptoms. IVST and PWT in group 1 patients (n = 10) were less than 10 mm, IVST and/or PWT in group 2 (n = 23) were 10 mm or greater, and the hypertensive patients in group 3 (n = 10) were in class III of the New York Heart Association Classification of hypertension. The IRT was prolonged in accordance with the increase in LVMI in groups 1 and 2. Though the LVMI showed no significant difference between normotensive controls and group 1, the IRT was significantly longer in group 1 patients (p < 0.05). The LVMI was markedly greater in group 3 than in group 2 (p < 0.01), but the IRT showed no significant difference. This finding indicates that there might be a limit of IRT prolongation associated with myocardial hypertrophy due to essential hypertension. In conclusion, IRT reflects the severity of left ventricular hypertrophy in patients with mild to moderate essential hypertension, but does not in advanced stages of hypertension.

Influence of left ventricular mass regression on cardiac function in hypertensive elderly individuals

A randomized, double-blind placebo controlled trial was conducted to compare the ability of verapamil and atenolol to induce regression of left ventricular mass in elderly hypertensive patients and the effects of regression on left ventricular filling, ejection fraction, and cardiac volumes. Forty-two individuals over 60 years of age were enrolled in the protocol. Eight of 21 patients assigned to atenolol and 18 to 21 assigned to verapamil achieved blood pressure control with single-agent therapy (p less than 0.05). The addition of chlorthalidone resulted in blood pressure control in the three remaining assigned to verapamil and in ten of the remaining patients assigned to atenolol. In the verapamil group left ventricular mass index decreased from 104 +/- 5 to 85 +/- 5 g/M2, while it was unchanged in the atenolol patients (109 +/- 9 to 112 +/- 10 g/M2). In the patients in whom the left ventricular mass regressed, the peak filling rate increased from 2.42 +/- 0.2 to 3.31 +/- 0.4 EDV/s, while it did not change in the patients who did not experience regression. Furthermore, ejection fraction and cardiac output were maintained in patients who had regression, both at rest and during mild upright bicycle exercise.