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[Echocardiographic follow-up in latent cardiomyopathy]
Insights
Follow-up of latent cardiomyopathy (LCM) patients shows no change in left ventricular size or function at rest. However, left bundle branch block (LBBB) may indicate worsening ventricular function over time.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Clinical Medicine
Context:
- Latent cardiomyopathy (LCM) is defined by abnormal left ventricular function during exercise in individuals with normal resting cardiac data.
- Previous follow-up studies on LCM patients' left ventricular dimensions and function have been limited.
- This study prospectively investigates the long-term cardiac changes in LCM patients.
Purpose:
- To assess changes in left ventricular dimensions and function in patients with latent cardiomyopathy over a mean follow-up of 3.3 years.
- To identify potential differences in disease progression between LCM patients with and without left bundle branch block (LBBB).
Summary:
- 36 LCM patients with normal resting cardiac parameters but abnormal exercise function were followed prospectively using clinical assessments and echocardiography.
- No significant changes in left ventricular end-diastolic dimensions, end-systolic diameter, or shortening fraction were observed at rest.
- Left atrial dimensions increased significantly in LCM patients compared to controls and over time.
- A subset of patients with LBBB showed a slight reduction in left ventricular contractions on 2D-echocardiography, not seen in patients without LBBB.
Impact:
- Findings suggest that for LCM patients without LBBB, resting left ventricular size and function remain stable over a 3.3-year follow-up.
- The study raises concerns about potential deterioration of left ventricular function in LCM patients who also have LBBB.
- Results highlight the importance of considering LBBB in the prognostic evaluation of latent cardiomyopathy.
Abstract:
Follow-up studies of left ventricular dimensions and function in latent cardiomyopathy (LCM) (as defined by abnormal left ventricular function during exercise in otherwise "normal" heart) have not yet been published. 36 patients with normal left ventricular data at rest (echocardiography, left ventricular angiography, coronary angiography, pulmonary artery pressure), but at least one pathologic function parameter during exercise, were studied prospectively by clinical means and by one- and two-dimensional echocardiography (mean follow-up 3.3 +/- 1.3 years). No patients died. The mean clinical class remained unchanged. The echocardiogram did not reveal an increase of left ventricular end-diastolic dimensions in any case. On average the end-systolic diameter of the left ventricle and shortening fraction in the M-mode echocardiogram did not change either. However, in 5 out of 9 patients with left bundle branch block the 2D-echocardiogram showed the development of a slight reduction of left ventricular contractions (without an increase in the end-diastolic dimensions). This was not to be observed in any patient without LBBB. Another finding was that the dimensions of the left atrium of LCM patients exceeded those of a group of normal subjects (p less than 0.02) with a further increase in the course of the disease (p less than 0.001). Thus, regarding the follow-up of patients with LCM without LBBB, there is no indication of any increase in the size of the left ventricle or reduction of its contractions at rest (mean follow-up 3.3 years). However, our results seem to underline the suspicion of a deterioration in left ventricular function of patients with LBBB.