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Influence of hereditary haemochromatosis on left ventricular wall thickness: does iron overload exacerbate cardiac
K Rozwadowska1, G Raczak2, K Sikorska3
1Clinical Centre of Cardiology, University Clinical Centre, Gdańsk, Poland.
Insights
Hereditary haemochromatosis (HH) can cause left ventricular (LV) hypertrophy, even in early stages. The duration of HH, not iron levels or comorbidities like hypertension, is linked to cardiac changes.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Left ventricular (LV) hypertrophy is a risk factor for heart failure.
- Hypertension and infiltrative cardiomyopathies are common causes of LV hypertrophy.
- Hereditary haemochromatosis (HH), linked to HFE gene mutations, involves excess iron deposition and is increasingly studied for cardiac effects.
Purpose of the Study:
- To investigate the influence of early-diagnosed and long-term treated HH on LV parameters.
- To compare cardiac parameters in HH patients with healthy controls.
Main Methods:
- Prospective enrollment of 39 early HH and 19 old HH patients.
- Age- and sex-matched healthy volunteers as control groups.
- Echocardiography (including 3D analysis) and iron turnover measurements.
Main Results:
- Early HH patients showed significantly higher left atrium (LA) and LV dimensions/mass, and lower LV ejection fraction compared to controls.
- Old HH patients exhibited similar changes, excluding LV ejection fraction.
- Correlation analysis revealed a strong link between time since HH diagnosis and LA/LV parameters, with no correlation to iron turnover or comorbidities.
Conclusions:
- HH, both early and long-standing, can exacerbate LV wall thickness and cardiac hypertrophy.
- This cardiac impact is primarily associated with the duration of HH, independent of hypertension and diabetes.
- The time elapsed since HH diagnosis is a key factor in cardiac remodeling.
Background:
The left ventricular (LV) hypertrophy increases the risk of heart failure. Hypertension and infiltrative cardiomyopathies are the well-known reasons of LV hypertrophy. The growing interest of scientists in this issue affects hereditary haemochromatosis (HH), which is characterised by the excess deposition of iron mostly due to HFE gene mutation. The aim of our study was to investigate the possible influence of HH on LV parameters in patients with early-diagnosed (early HH) and long-lasting and long-treated (old HH) disease.
Materials And Methods:
Thirty nine early HH and 19 old HH patients were prospectively enrolled in the study; age- and sex-matched healthy volunteers constituted the appropriate control groups. All participants had echocardiography performed (including three-dimension volume and mass analysis); the iron turnover parameters were measured at the time of enrolment in every HH patients.
Results:
Echocardiographic parameters regarding to left atrium (LA), LV thickness, mass and long axis length were significantly higher, whereas LV ejection fraction was lower in early HH in comparison to healthy persons. In old HH patients the differences were similar to those mentioned before, except LV ejection fraction. The presence of hypertension in both HH groups did not influence echo parameters, as well as diabetes in old HH. The strongest correlation in all HH group was found between the time from HH diagnosis and LA, LV thickness and volumes parameters, but the correlations between iron turnover and echo parameters were non-existent.
Conclusions:
Hereditary haemochromatosis, not only long-lasting, but also early-diagnosed, could lead to exacerbation of LV wall thickness and cardiac hypertrophy. This effect is not simply connected with hypertension and diabetes that are frequent additional diseases in these patients, but with the time from HH diagnosis.
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