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Association of Concentric Left Ventricular Hypertrophy With Subsequent Change in Left Ventricular End-Diastolic

Sonia Garg1, James A de Lemos2, Susan A Matulevicius2

  • 1From the Division of Cardiology, Department of Internal Medicine (S.G., J.A.d.L., S.A.M., A.P., I.J.N., J.D.B., M.H.D.), Department of Clinical Science (C.A., J.D.B.), and Department of Radiology (R.M., C.M., R.M.P.), University of Texas Southwestern Medical Center, Dallas. sonia.garg@utsouthwestern.edu.

Circulation. Heart Failure
|August 5, 2017
PubMed

Insights

Concentric hypertrophy, a thickened left ventricle (LV), showed a slight increase in LV end-diastolic volume over 7 years without heart attacks. Progression to dilated cardiomyopathy was rare, suggesting a much longer development time.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Cardiac Imaging

Background:

  • The conventional view suggests left ventricular hypertrophy (LVH) progresses to dilated cardiomyopathy.
  • Limited human data exist on this transition without myocardial infarction.
  • Investigating the progression of LVH without prior cardiac events is crucial.

Purpose of the Study:

  • To examine the association between concentric hypertrophy and left ventricular (LV) dilation over time.
  • To determine if LVH commonly progresses to dilated cardiomyopathy in the absence of myocardial infarction.
  • To assess the rate of LV end-diastolic volume (EDV) change in individuals with and without concentric hypertrophy.

Main Methods:

  • Serial cardiac magnetic resonance imaging (CMR) was performed on 1282 participants from the Dallas Heart Study approximately 7 years apart.
  • Participants with interval cardiovascular events or baseline dilated LV were excluded.
  • Multivariable linear regression models analyzed the link between baseline concentric hypertrophy and changes in LV end-diastolic volume (LVEDV).

Main Results:

  • 11% of participants (n=142) had baseline concentric hypertrophy.
  • Concentric hypertrophy was associated with a significantly greater increase in LVEDV (1 mL) compared to those without (-2 mL) over 7 years (P<0.01).
  • Progression to a dilated LV was uncommon, observed in only 2% (n=25) of the cohort.

Conclusions:

  • Concentric hypertrophy is linked to a small but significant increase in LVEDV over 7 years, independent of myocardial infarction.
  • The observed LV enlargement was minimal, and progression to dilated LV was infrequent.
  • These findings suggest that the transition from concentric hypertrophy to dilated cardiomyopathy may take decades and is less common than previously assumed.
Abstract

Keywords:
animalsdilation, left ventricularhearthypertrophy, left ventricular

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