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[Regional right ventricular hypertrophy in hypertrophic cardiomyopathy and hypertension]
Insights
Right ventricular hypertrophy (RVH) and asymmetric hypertrophy (AH) are more common in hypertrophic cardiomyopathy (HCM) and hypertensive asymmetric septal hypertrophy (HT-ASH) than in mild hypertension. Two-dimensional echocardiography (2DE) assessed these conditions.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Context:
- Hypertrophic cardiomyopathy (HCM) and hypertension (HT) can lead to cardiac structural changes.
- Right ventricular hypertrophy (RVH) and asymmetric hypertrophy (AH) are specific manifestations of cardiac remodeling.
- Two-dimensional echocardiography (2DE) is a key diagnostic tool for assessing cardiac morphology.
Purpose:
- To compare the prevalence of right ventricular hypertrophy (RVH) and asymmetric hypertrophy (AH) in patients with hypertrophic cardiomyopathy (HCM) versus different categories of hypertensive heart disease.
- To utilize two-dimensional echocardiography (2DE) to quantify right ventricular wall thickness and identify hypertrophic patterns.
Summary:
- Echocardiographic assessment of 24 HCM patients and 51 hypertensive patients revealed distinct patterns of right ventricular hypertrophy (RVH).
- The incidence of RVH and AH was significantly higher in HCM (67% RVH, 41% AH) and hypertensive patients with asymmetric septal hypertrophy (HT-ASH) (57% RVH, 45% AH) compared to mild hypertension (15% RVH, 11% AH).
- Right ventricular hypertrophy with asymmetric hypertrophy was more frequent in HCM and HT-ASH groups.
Impact:
- Highlights the increased likelihood of right ventricular remodeling in HCM and specific hypertensive heart disease subtypes.
- Underscores the utility of echocardiography in differentiating cardiac conditions based on ventricular hypertrophy patterns.
- Provides valuable data for understanding the spectrum of right ventricular involvement in cardiomyopathies and hypertensive heart disease.
Abstract:
The mode of right ventricular hypertrophy was assessed by two-dimensional echocardiography (2DE) for 24 patients with hypertrophic cardiomyopathy (HCM), and the results were compared with those of 51 patients with hypertension (HT). The patients with HT were categorized in four groups depending on the thickness of the interventricular septum (IVST) and left ventricular posterior wall (PWT): HT-ASH with both left ventricular hypertrophy (LVH) (IVST greater than or equal to 13 mm) and asymmetric septal hypertrophy (ASH) (IVST/PWT greater than or equal to 1.3), severe HT with LVH and without ASH, and mild HT without LVH and ASH. Anterior wall thickness (AWT), posterior wall thickness (PWT), and diaphragmatic wall thickness (DWT) of the right ventricle were obtained from 2DE in the parasternal long-axis view, the short-axis view and subxiphoid view, respectively. These were recorded on video tape, and the measurements were made on the stop frames. Right ventricular hypertrophy (RVH) was estimated by the maximal right ventricular wall thickness (max RVWT), and the ratio of the maximal and minimal thickness (max RVWT/min RVWT) was calculated to evaluate asymmetrical hypertrophy (AH) of the right ventricle (RV). The incidence of RVH (Max RVWT greater than or equal to 5 mm) and asymmetrical hypertrophy (AH) (max RVWT/min RVWT greater than or equal to 1.3) of the RV in HCM, HT-ASH and mild HT were 67% and 41%, 57% and 45%, and 15% and 11%, respectively. The incidence of RVH with AH was more frequent in patients with HCM as well as HT with ASH than in patients with HT without ASH.(ABSTRACT TRUNCATED AT 250 WORDS)