LV Mass Assessed by Echocardiography and CMR, Cardiovascular Outcomes, and Medical Practice

Abstract

We investigate three important areas related to the clinical use of LVM (LVM): accuracy of assessments by echocardiography and cardiac magnetic resonance (CMR), the ability to predict cardiovascular outcomes, and the comparative value of different indexing methods. The recommended formula for echocardiographic estimation of LVM uses linear measurements and is based on the assumption of the left ventricle as a prolate ellipsoid of revolution. CMR permits a modeling of the left ventricle free of cardiac geometric assumptions or acoustic window dependency, showing better accuracy and reproducibility. However, echocardiography has lower cost, easier availability, and better tolerability. From the Medline database, 26 longitudinal echocardiographic studies and 5 CMR studies, investigating LVM or LV hypertrophy as predictors of death or major cardiovascular outcomes, were identified. LVM and LV hypertrophy were reliable cardiovascular risk predictors using both modalities. However, no study directly compared the methods for the ability to predict events, agreement in hypertrophy classification, or performance in cardiovascular risk reclassification. Indexing LVM to BSA was the earliest normalization process used, but it seems to underestimate the prevalence of hypertrophy in obese and overweight subjects. Dividing LVM by height to 1.7 or 2.7 as allometric powers are the most promising normalization methods in terms of practicality and usefulness from a clinical ans scientific standpoints for scaling myocardial mass to body size. The measurement of LVM, calculation of LVMi, and classification for LVH should be standardized by scientific societies across measurement techniques and adopted by clinicians in risk stratification and therapeutic decision.

Serum level of apelin-13 negatively correlated with NT-proBNP in heart failure patients

“…The EF%, LV end-diastolic and end-systolic volumes were calculated using the Simpson biplan method. The LV mass was calculated from end-diastolic LV internal diameter, interventricular septum and posterior wall dimensions using the ASE formula [33,34], and indexed for body surface calculated with the Dubois formula.…”

Association of Cardiac Structural and Functional Abnormalities With Gestational Diabetes

“…(13,14) Moreover, LV mass is a powerful predictor of major cardiovascular outcomes; even in early adulthood, when CV risk factors exposition is still incipient. (15,16) Therefore, LV mass index raises as an early marker of cardiac remodeling in patients with gestational diabetes. Myocardial hypertrophy is an important marker of cardiac remodeling and may be presented in the earlier stages of gestational diabetes-related cardiac injury; while diastolic and systolic dysfunction appear later, after the heart loses its functional compensatory mechanisms.…”

Incidence of sustained ventricular tachycardia and ventricular fibrillation in patients with cardiac scar zones and low vs. normal left ventricular ejection fraction

“…Left ventricular end-systolic (LVESVI) and end-diastolic volume index (LVEDVI) were normalized in every patient for sex, age, height, and weight, and LVESVI and LVEDVI have been assessed [13]. LVM has then normalized indexing to body surface area (g/m 2 ) [14]. Left ventricular ejection fraction (LVEF) was calculated by Simpson's method.…”