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[Myocardial hypertrophy in stenosing arteriosclerosis of the abdominal aorta]
Insights
Abdominal aortic stenosis causes left ventricular hypertrophy by increasing resistance to blood flow. Surgical repair normalized heart mass in normal blood pressure patients, while reducing it in hypertensive patients.
Area of Science:
- Cardiovascular Surgery
- Clinical Cardiology
- Vascular Medicine
Background:
- Abdominal aortic stenosis or occlusion can lead to significant cardiovascular changes.
- Left ventricular hypertrophy is a known adaptation to increased afterload.
Purpose of the Study:
- To investigate the impact of terminal abdominal aorta stenosis/occlusion on left ventricular myocardial mass and end-diastolic volume.
- To assess the reversibility of these cardiac changes after surgical intervention.
Main Methods:
- Echocardiographic measurements of myocardial mass and end-diastolic volume were performed in 57 patients.
- Measurements were taken pre-operatively and 15-20 days post-operatively following aortic shunting or prosthesis.
Main Results:
- Pre-operatively, 77.2% of patients exhibited increased left ventricular myocardial mass.
- In normotensive patients, hypertrophy was due to wall thickening; in hypertensive patients, both wall thickening and increased end-diastolic volume were observed.
- Post-operatively, myocardial mass normalized in normotensive patients and decreased in hypertensive patients, along with end-diastolic volume.
Conclusions:
- Myocardial hypertrophy in abdominal aorta stenosis/occlusion is a direct response to increased left ventricular ejection resistance.
- Surgical correction effectively reverses cardiac remodeling, with outcomes varying based on pre-operative blood pressure levels.
Abstract:
In 57 patients with stenosis or occlusion of the terminal segment of abdominal aorta the authors measured the myocardial mass and the end diastolic volume of the left ventricle before the operation and 15-20 days after it (shunting or prosthesis of bifurcation of the abdominal aorta). Prior to operation increase of the myocardial mass of the left ventricle was found in 77.2% of patients. Patients with normal blood pressure had an increase in the myocardial mass at the expense of the thickening of the ventricular wall only, in patients with increased BP there was an increase in the thickness of the ventricular wall and also in the end diastolic volume. After the operation in patients with normal BP myocardial mass of the left ventricle reverted to normal. In patients with high BP the myocardial mass and the end diastolic volume of the left ventricle decreased. Myocardial hypertrophy in the patients studied is due to the increased resistance to blood ejection from the left ventricle caused by stenosis or occlusion of the abdominal aorta.