Echocardiographic Diagnosis of Idiopathic Hypertrophic Cardiomyopathy without Outflow Obstruction

Abbasi, Abdul S.; MacAlpin, Rex N.; Eber, Leslie M.; Pearce, Morton Lee

doi:10.1161/01.cir.46.5.897

Cited by 154 publications

(20 citation statements)

References 19 publications

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“…In this study 32% of patients with chronic renal failure with hypertension had ASH, while Abbasi'8 and Schott'9 reported 39% and 5% of patients, respec- Maron reported ASH in 10% of aortic stenosis patients. 6 The ratio was normal (1.03 ± 0.06) in 11 ASH may be an early marker of concentric left ventricular hypertrophy due to its occasional presence in aortic valvular disease and hypertensive patients in the absence of abnormally increased left ventricular posterior wall thickness, and one presumes that with the progression of the disease, concentric hypertrophy will develop. This view is consistent with that of Bahler.…”

Section: Methodsmentioning

confidence: 98%

Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.

Kansal¹,

Roitman²,

Sheffield³

1979

Circulation

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SUMMARY Septal and left ventricular posterior wall (LVPW) thicknesses and their ratios were studied at the left ventricular outflow tract and left ventricular cavity in 66 patients with echocardiographically diagnosed left ventricular concentric hypertrophy, 20 with idiopathic hypertrophic subaortic stenosis (IHSS), and 34 normal subjects. Concentric hypertrophy was due to hypertension in 41 subjects and to valvular disease in 15 subjects. Septal thickness in normal subjects was related to body surface area (p < 0.02). In 12% of normal subjects, 39% of patients with concentric hypertrophy and 95% with IHSS, the septal/LVPW ratio was 2 1.3. Thirty-two percent of patients with hypertension, 78% with aortic stenosis, and 60% with aortic insufficiency had septal/LVPW ratios 1.3 at left ventricular midcavity level.In conclusion, a septal/LVPW thickness ratio of 1.3 is common in patients with concentric left ventricular hypertrophy and may also occur in normal subjects. A ratio 1.5 may be more specific for genetically determined asymmetric septal hypertrophy.SINCE THE INTRODUCTION of the term asymmetric septal hypertrophy (ASH) in 1973,1 controversy has arisen regarding its clinical and echocardiographic significance. The diagnosis of ASH is based on echocardiographic analysis that shows disproportionate septal thickness and a ratio of septal-toleft ventricular free wall of 1.3 or more.2This specific ratio has led to study of the septum and its relationi to the left ventricular free wall in many congenital and acquired cardiac diseases, and has revealed that many diseases, such as pulmonary hypertension,3 pulmonary stenosis,4 congenital malformation of the mitral valve,' 6 coarctation of the

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Section: Methodsmentioning

confidence: 98%

Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.

Kansal¹,

Roitman²,

Sheffield³

1979

Circulation

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“…Abbassi A.S. в 1972 г. продемонстрировал асси-метричную гипертрофию миокарда, и соотношение межжелудочковой перегородки к задней стенке ле-вого желудочка было не менее 2,0 [31,32].…”

Section: исследования патофизиологии и диагностика гипертрофической кunclassified

Historical and modern aspects of diagnostics and treatment of hypertrophic cardiomyopathy: literature review

Kashtanov¹,

Идов²

2016

Circ Patol Card Surg

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“…Types II-A, II-B and II-C disorganization involved areas of myocardium that included both longitudinally and transversely cut cardiac muscle cells. Nonparallel arrangements of cardiac muscle cells were not considered to represent disorganization if present in the following areas where cells normally converge at acute angles: (1) at or near the junction of ventricular septum with the left and right ventricular free walls, (2) within trabeculations, (3) within or at the edges of scarred areas, (4) at points of convergence of major muscle bundles, or (5) adjacent to interstitial spaces containing blood vessels.…”

Section: Definition and Classification Of Cardiac Muscle Cell Disorgamentioning

confidence: 99%

Quantitative analysis of the distribution of cardiac muscle cell disorganization in the left ventricular wall of patients with hypertrophic cardiomyopathy.

Maron¹,

Anan²,

Roberts³

1981

Circulation

204

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SUMMARY The distribution of cardiac muscle cell disorganization in different regions of the left ventricular wall was studied quantitatively in 52 patients with hypertrophic cardiomyopathy. Cellular disorganization in the ventricular septum was both common and extensive (mean area of septal tissue section disorganized, 35 i 4%). Disorganization was also substantial (24 ± 3%) in the left ventricular free wall of these patients, although less marked than in the ventricular septum (p < 0.05). Anterior left ventricular free wall disorganization was particularly extensive (32 ± 4%) and did not differ significantly from that present in the ventricular septum. Marked cardiac muscle cell disorganization (> 5% of the tissue section) was diffusely distributed in the ventricular septum and left ventricular free wall in 33 of the 52 patients (63%).Particularly marked left ventricular free wall and combined free wall and septal disorganization was present in 14 patients without functional limitation in whom sudden death occurred early in life (< 25 years of age) and was the initial manifestation of cardiac disease. In contrast, although abnormally arranged cardiac muscle cells were identified in the left ventricular free wall in 47% of patients with other congenital or acquired heart diseases or normal hearts, this disorganization was usually limited in extent (mean area of section disorganized, 2 0.5%).Hence, in a large population of patients with hypertrophic cardiomyopathy, cellular disorganization was widely distributed throughout both the ventricular septum and left ventricular free wall. No definitive conclusions can be made regarding the significance of this distribution of cellular disorganization; however, our data suggest that this pattern may represent a diffuse cardiomyopathic process and be a determinant of clinical outcome in certain patients with hypertrophic cardiomyopathy.HYPERTROPHIC CARDIOMYOPATHY is a disease of cardiac muscle that is characterized by a hypertrophied, nondilated left ventricle' and, in most patients, asymmetric septal hypertrophy.2`6 Marked disorganization of cardiac muscle cells in the ventricular septum7-10 has also been shown by quantitative histologic analysis to be a highly specific and sensitive anatomic hallmark of hypertrophic cardiomyopathy.1' '3 Qualitative histologic studies have shown that cellular disorganization may also be present in the left ventricular free wall of patients with hypertrophic cardiomyopathy.?' ' In this study, we quantitated, for the first time, the extent of cellular disorganization in both the ventricular septum and left ventricular free wall of patients with hypertrophic cardiomyopathy compared with patients with other forms of cardiac hypertrophy; we also determined whether the distribution and extent of the cellular disorganization in patients with hypertrophic cardiomyopathy has significance with regard to clinical course or hemodynamic state.

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Echocardiographic Diagnosis of Idiopathic Hypertrophic Cardiomyopathy without Outflow Obstruction

Cited by 154 publications

References 19 publications

Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.

Interventricular septal thickness and left ventricular hypertrophy. An echocardiographic study.

Historical and modern aspects of diagnostics and treatment of hypertrophic cardiomyopathy: literature review

Quantitative analysis of the distribution of cardiac muscle cell disorganization in the left ventricular wall of patients with hypertrophic cardiomyopathy.

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