Related Experiment Video
Updated: Jan 7, 2026
Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices
Published on: September 8, 2023
Factors influencing cardiomegaly and cardiac size changes after endovascular treatment in peripheral arteriovenous
Jun Gon Kim1, Myung Sub Kim2, Sang Yub Lee1
1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Insights
Peripheral arteriovenous malformations (AVMs) are linked to cardiomegaly, with specific types and locations increasing risk. Endovascular treatment effectively reduces cardiac enlargement and improves function in some patients.
Area of Science:
- Vascular Surgery
- Cardiology
- Radiology
Background:
- Peripheral arteriovenous malformations (AVMs) diagnosis and treatment are established, but cardiomegaly prevalence and risk factors are understudied.
- Cardiomegaly, an enlarged heart, can be a complication of AVMs, impacting patient health.
- Understanding these associations is crucial for comprehensive AVM management.
Purpose of the Study:
- To determine the prevalence of cardiomegaly in patients with peripheral AVMs.
- To identify risk factors associated with cardiomegaly in this population.
- To evaluate the impact of endovascular treatment on cardiac size and function.
Main Methods:
- Retrospective review of 437 patients with peripheral AVMs treated between 2000-2022.
- AVM classification using the Cho-Do angiographic system.
- Cardiomegaly defined as cardiothoracic ratio (CTR) >0.5; statistical analysis of risk factors and post-treatment changes.
Main Results:
- Cardiomegaly was present in 24.7% of patients.
- Significant risk factors included AVM types I/II, lesion diameter >10 cm, and bone involvement.
- Abdominopelvic and thoracic-neck AVMs showed higher prevalence; endovascular treatment reduced CTR by 8.9% and improved cardiac function in 44% of assessed patients.
Conclusions:
- AVM type, extent, location, and bone involvement are key factors for cardiomegaly risk.
- Endovascular treatment demonstrates efficacy in reducing cardiac enlargement.
- Functional cardiac improvement is achievable post-treatment in a subset of patients.
Abstract:
BackgroundAlthough prior studies on peripheral arteriovenous malformations (AVMs) have addressed diagnosis and treatment, the prevalence and risk factors for cardiomegaly remain underexplored.PurposeTo assess the prevalence of cardiomegaly in peripheral AVMs, identify associated factors, and evaluate changes in cardiac size and function following endovascular treatment.Material and MethodsA retrospective review was conducted on 437 patients treated for peripheral AVMs between 2000 and 2022 at a single vascular anomalies center. AVM types were classified according to the Cho-Do angiographic classification. Cardiomegaly was defined as a cardiothoracic ratio (CTR) >0.5 on chest radiographs. Factors associated with cardiomegaly and post-treatment changes in CTR and cardiac function were analyzed.ResultsCardiomegaly was observed in 108/437 (24.7%) patients. Multivariate analysis identified type I/II (vs. III) (P = 0.002), lesion diameter >10 cm (P = 0.013), and bone involvement (P = 0.021) as significant risk factors. Abdominopelvic (P <0.001) and thoracic-neck AVMs (P = 0.018) had higher cardiomegaly prevalence than extremity AVMs. Among the 108 patients with cardiomegaly, 84 underwent follow-up chest radiographs. The median CTR reduction rate was 8.9% (interquartile range [IQR] 4.1-15.8), with a significant decrease (P <0.001). Higher angiographic devascularization was associated with greater CTR reductions (P = 0.013). Echocardiography was selectively performed in patients with suspected cardiac involvement. Among 27 patients with both pre- and post-treatment echocardiography, 44% showed functional improvement.ConclusionAVM type, extent, location, and bone involvement were significant factors influencing cardiomegaly risk. Endovascular treatment was effective in reducing cardiac enlargement and functional improvement was observed in a subset of patients.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
01:29Cardiomyopathy V: Interprofessional Care
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:22Aneurysm IV: Nursing Management
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...