Asymmetric septal hypertrophy – a marker of hypertension in aortic stenosis (a SEAS substudy)

Tuseth, Nora; Cramariuc, Dana; Rieck, Ashild E; Wachtell, Kristian; Gerdts, Eva

doi:10.3109/08037051.2010.481816

Cited by 36 publications

(26 citation statements)

References 26 publications

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“…According to the recent American College of Cardiology Foundation/ American Heart Association guidelines, HCM is usually recognized by a regional increase in LV wall thickness ≥15.0 mm, with measurements of 13 and 14 mm considered borderline. 5 However, such asymmetrical wall thickening has also been described in both aortic stenosis and hypertension, [6][7][8] and we postulated that it might develop in response to strenuous physical training as well.…”

Section: Clinical Perspective On P 267mentioning

confidence: 82%

“…7,9 In brief, 541 consecutive healthy young white men army recruits were prospectively studied at entry to the British Army Training Regiment, Lichfield, United Kingdom, between July 2002 and April 2004. Recruits with an established diagnosis of hypertension, diabetes mellitus, cardiomyopathy, and those on regular medication were excluded.…”

Section: Study Recruitsmentioning

confidence: 99%

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Left Ventricular Wall Thickness and the Presence of Asymmetric Hypertrophy in Healthy Young Army Recruits

Lee

Dweck²,

Prasher

et al. 2013

Circ: Cardiovascular Imaging

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Background— To use cardiovascular magnetic resonance to investigate left ventricular wall thickness and the presence of asymmetrical hypertrophy in young army recruits before and after a period of intense exercise training. Methods and Results— Using cardiovascular magnetic resonance, the left ventricular wall thickness was measured in all 17 segments and a normal range was calculated for each. The prevalence of asymmetrical wall thickening was assessed before and after training and defined by a ventricular wall thickness ≥13.0 mm that was >1.5× the thickness of the opposing myocardial segment. Five hundred forty-one men (mean age, 20±2 years) were recruited, 309 underwent repeat scanning. Considerable variation in wall thickness was observed across the ventricle with progressive thickening on moving from the apex to base ( P <0.001) and in the basal and midcavity septum compared with the lateral wall (11.0±1.4 versus 10.1±1.3 mm; P <0.001). Twenty-three percent had a maximal wall thickness ≥13.0 mm, whereas the prevalence of asymmetrical wall thickening increased from 2.2% to 10% after the exercise-training program. In those who developed asymmetry, the wall thickness/diastolic volume ration remained normal (0.09±0.02 mm⋅m 2 ⋅mL −1 ), indicative of a remodeling response to exercise. Conclusions— In a cohort of healthy young white men, we have demonstrated that wall thickness frequently measures ≥13.0 mm and that asymmetrical wall thickening is common and can develop as part of the physiological response to exercise. A diagnosis of hypertrophic cardiomyopathy in young athletic men should, therefore, not be made purely on the basis of regional wall thickening.

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Section: Clinical Perspective On P 267mentioning

confidence: 82%

Section: Study Recruitsmentioning

confidence: 99%

Left Ventricular Wall Thickness and the Presence of Asymmetric Hypertrophy in Healthy Young Army Recruits

Lee

Dweck²,

Prasher

et al. 2013

Circ: Cardiovascular Imaging

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“…Furthermore, hypertension can be an aggravating factor in the progression of aortic stenosis, and its control is important to slow down the progression of valve disease 19 . Tuseth et al 20 found that hypertension is associated with a greater presence of asymmetric septal hypertrophy in patients with asymptomatic aortic stenosis, regardless of the severity of the stenosis, a condition that worsens the prognosis of surgery.…”

Section: Discussionmentioning

confidence: 99%

Impacto da hipertensão arterial no remodelamento ventricular, em pacientes com estenose aórtica

Hueb

Vicentini

Roscani

et al. 2011

Arq. Bras. Cardiol.

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“…We evaluated whether these parameters could differentiate between normal controls and severe AS patients on the basis of the clinical knowledge that the LV response to aortic stenosis includes LV remodeling 23 , 24 , 25 , 26 , 27 , 28 . MATLAB R2013a (MathWorks, Natick, MA) was used to perform paired t ‐tests and a diagnostic classification test.…”

Section: Methodsmentioning

confidence: 99%

Patient‐specific 17‐segment myocardial modeling on a bull's‐eye map

Jung

Kim

et al. 2016

J Applied Clin Med Phys

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The purpose of this study was to develop and validate cardiac computed tomography (CT) quantitative analysis software with a patient‐specific, 17‐segment myocardial model that uses electrocardiogram (ECG)‐gated cardiac CT images to differentiate between normal controls and severe aortic stenosis (AS) patients. ECG‐gated cardiac CT images from 35 normal controls and 144 AS patients were semiautomatically segmented to create a patient‐specific, 17‐segment myocardial model. Two experts then manually determined the anterior and posterior interventricular grooves to be boundaries between the 1st and 2nd segments and between the 3rd and 4th segments, respectively, to correct the model. Each segment was automatically identified as follows. The outer angle of two boundaries was divided to differentiate the 1st, 4th, 5th, and 6th segments in the basal plane, whereas the inner angle divided the 2nd and 3rd segments. The segments of the midplane were similarly divided. Segmental area distributions were quantitatively evaluated on the bull's‐eye map on the basis of the morphological boundaries by measuring the area of each segment. Segmental areas of severe AS patients and normal controls were significantly different (t‐test, all p‐values<0.011) in the proposed model because the septal regions of the severe AS patients were smaller than those of normal controls and the difference was enough to divide the two groups. The capabilities of the 2D segmental areas (p<0.011) may be equivalent to those of 3D segmental analysis (all p‐values<0.001) for differentiating the two groups (t‐test, all p‐values<0.001). The proposed method is superior to the conventional 17‐segment in relation to reflection of patient‐specific morphological variation and allows to obtain a more precise mapping between segments and the AHA recommended nomenclature. It can be used to differentiate severer AS patients and normal controls and also helps to understand the left ventricular morphology at a glance.PACS number(s): 87.57.N‐, 87.57.R‐, 87.57.qp

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Asymmetric septal hypertrophy – a marker of hypertension in aortic stenosis (a SEAS substudy)

Abstract: Hypertension is the main clinic characteristic of ASH and asymmetric LV hypertrophy in patients with asymptomatic aortic stenosis independent of severity of aortic stenosis.

Cited by 36 publications

References 26 publications

Left Ventricular Wall Thickness and the Presence of Asymmetric Hypertrophy in Healthy Young Army Recruits

Left Ventricular Wall Thickness and the Presence of Asymmetric Hypertrophy in Healthy Young Army Recruits

Impacto da hipertensão arterial no remodelamento ventricular, em pacientes com estenose aórtica

Patient‐specific 17‐segment myocardial modeling on a bull's‐eye map

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