Effects of carvedilol on left ventricular function, mass, and scintigraphic findings in isolated left ventricular non-compaction

Toyono, Manatomo; Kondo, Chisato; Nakajima, Yoshiyuki; Nakazawa, Makoto; Momma, Kazuo; Kusakabe, Kiyoko

doi:10.1136/heart.86.1.e4

Cited by 83 publications

(72 citation statements)

References 8 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 The association of LVHT with embolism is in other's and our experience 11,12 not as high as previously reported. 7 Did the patient suffer from any embolic events during her lifetime?…”

Section: Uncertainties In Left Ventricular Hypertrabeculation/noncompcontrasting

confidence: 41%

Uncertainties in Left Ventricular Hypertrabeculation/Noncompaction

Stöllberger

Finsterer

2005

Circ J

View full text Add to dashboard Cite

We read with interest the article by Sakuma et al of a 65-year-old woman in whom echocardiography revealed left ventricular hypertrabeculation/noncompaction (LVHT), and who died 5 years later from heart failure and ventricular fibrillation. 1 However, we want to mention the following concerns. The authors say that LVHT is exclusively a congenital disorder and do not seem aware that indivdual patients may acquire LVHT during their lifetime. Three members of a family who subsequently developed LVHT did not show characteristic changes on the fetal echocardiographic studies and therefore in those cases LVHT developed either postnatally or was not visible on fetal echocardiography. 2 In a further case, LVHT was not echocardiographically present in the first days of life and manifested at the age of 5 weeks. 3 In another case, LVHT was documented to develop during the subject's lifetime. 4,5 Overall, the etiology of LVHT remains unknown.The authors describe LVHT as a rare disorder, but it has to be mentioned that LVHT is frequently overlooked and that its recognition depends on the awareness of the echocardiographers and the available technology. Thus, the prevalence of LVHT is at present also unknown. According to our experience in an echocardiographic laboratory, the prevalence of LVHT in adults is 0.25%/year. 6 The echocardiographic diagnostic criteria for LVHT are only one of several different definitions of LVHT. 7 Why did the authors chose that particular definition, and would all 9 patients also fulfill the other 2 criteria for LVHT? 8,9 It would be interesting to know how the authors differentiated between trabeculations, papillary muscles and tendinal chords when quantifying the extent of the trabecular meshwork at the level of the mitral valve and at the level of the papillary muscles. Were the intertrabecular recesses measurable and detectable at each location of LVHT?Did the morphology of LVHT change during follow-up, as has been reported in a patient with LVHT in whom after successful pharmacological therapy, an increase in left ventricular ejection fraction and a decrease in both left ventricular volume and end-diastolic pressure were associated with a decrease of the non-compacted myocardial areas? 10 The association of LVHT with embolism is in other's and our experience 11,12 not as high as previously reported. 7 Did the patient suffer from any embolic events during her lifetime? Did she receive oral anticoagulants?The oldest patient with LVHT, so far reported, is 80 years old. 13 It would be of interest to know the previous history of the presented patient, her laboratory and electrocardiographic findings and results of neurologic examinations because neuromuscular disorders are a frequent finding in patients with LVHT. 9 Regarding the pathoanatomic and pathohistological findings, it would be of interest to know the size and age of the thrombi and if conductive structures could be detected in the trabeculations. Did the authors recognize the intertrabecular thrombi already intra vitam by echocardiogra...

show abstract

“…10 The association of LVHT with embolism is in other's and our experience 11,12 not as high as previously reported. 7 Did the patient suffer from any embolic events during her lifetime?…”

Section: Uncertainties In Left Ventricular Hypertrabeculation/noncompcontrasting

confidence: 41%

Uncertainties in Left Ventricular Hypertrabeculation/Noncompaction

Stöllberger

Finsterer

2005

Circ J

View full text Add to dashboard Cite

show abstract

“…14 The beneficial effects of the ␤-blocker carvedilol on left ventricular function, mass, and neurohormonal dysfunction in an infant with INVM have been described. 33 Because of the frequency of ventricular tachycardia and significant risk of sudden cardiac death and systemic embolism, assessment for atrial and ventricular arrhythmias by ambulatory ECG monitoring should be performed annually. As more information is gathered about NVM and risk of sudden cardiac death, implantable defibrillator technology may have an expanded role.…”

Section: Managementmentioning

confidence: 99%

Noncompaction of the Ventricular Myocardium

2004

View full text Add to dashboard Cite

ase Presentation: A 42-yearold woman was referred to the Hypertrophic Cardiomyopathy Clinic. A diagnosis of apical hypertrophic cardiomyopathy had been given 16 years earlier on the basis of echocardiographic findings. Left ventricular systolic function was reportedly at the lower limit of normal 5 years earlier.The patient gave a 6-month history of mild dyspnea occurring during exertion. Although still active, her exercise tolerance had decreased. She also complained of more frequent and sustained episodes of rapid palpitations associated with shortness of breath. She had occasional episodes of heavy, burning discomfort in the chest during activity and while at rest.There was no family history of cardiomyopathy, although first degree relatives had not been screened. Her heart rate was 74. Blood pressure was 110/ 70. Jugular venous pressure was normal. Carotid pulse volume and contour were normal. The first and second heart sounds were normal. There was a presystolic apical impulse and a prominent S4 gallop. There was no S3 gallop. A grade III/VI, harsh, midsystolic murmur was heard best at the upper left sternal border. There was no diastolic murmur.The ECG showed sinus rhythm, normal QRS duration, and left ventricular hypertrophy with repolarization changes. An echocardiogram demonstrated marked thickening and heavy trabeculation of the apical half of the left ventricle. Color Doppler displayed flow within the deep intertrabecular recesses. The left ventricle was not dilated. There was diffuse left ventricular hypokinesis with an ejection fraction of 20% to 25%. The right ventricle appeared to be more heavily trabeculated than usual. No additional abnormalities were present. The findings were consistent with isolated noncompaction of the ventricular myocardium.

show abstract

“…Patients with LVNC are managed with neurohormonal blockade, diuretics, and cardiac resynchronization/defibrillator therapy according to standard clinical guidelines for systolic and diastolic dysfunction though there has been limited study validating their efficacy in this population. One case study found that carvedilol improved EF, left ventricular dimensions, and left ventricular mass in an infant with isolated LVNC [79]. In another study of 10 children, carvedilol was associated with stabilization or improvement in ventricular function in 7 patients [11].…”

Section: Managementmentioning

confidence: 97%

Left Ventricular Non-Compaction: Current Controversy and New Insights

E¹

2015

J Genet Syndr Gene Ther

View full text Add to dashboard Cite

Left ventricular non-compaction is an increasingly recognized familial cardiomyopathy characterized morphologically by deep myocardial trabeculations and a highly variable, but potentially aggressive clinical course leading to cardiac death or cardiac transplantation. Great controversy exists regarding the pathophysiology, diagnostic approach, clinical characteristics, and management of the condition. To date, there are no universally accepted precise diagnostic criteria or management guidelines. Recent clinical studies and basic science research have significantly added to our understanding of LVNC in all of these aspects. This article reviews the literature to date on LVNC and addresses current controversies surrounding the pathophysiology, diagnosis, clinical features, and management.

show abstract

Effects of carvedilol on left ventricular function, mass, and scintigraphic findings in isolated left ventricular non-compaction

Cited by 83 publications

References 8 publications

Uncertainties in Left Ventricular Hypertrabeculation/Noncompaction

Uncertainties in Left Ventricular Hypertrabeculation/Noncompaction

Noncompaction of the Ventricular Myocardium

Left Ventricular Non-Compaction: Current Controversy and New Insights

Contact Info

Product

Resources

About