Magnitude of left ventricular hypertrophy and risk of sudden death in hypertrophic cardiomyopathy

Article Abstract:

In patients with hypertrophic cardiomyopathy, the thicker the heart muscle is, the higher their risk of sudden death. Hypertrophic cardiomyopathy is a heart disease caused by increased thickness of the heart muscle. In a study of 480 patients with hypertrophic cardiomyopathy, 14% died over a 6-year period. Those with the thickest heart muscle were most likely to die, even if they had few symptoms. Many of the patients with the thickest heart muscle were young and had mild symptoms or no symptoms at all.

Health aspects, Causes of, Prognosis, Sudden death, Heart enlargement, Heart hypertrophy

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The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes

Article Abstract:

The left ventricle (LV) of the heart is the chamber responsible for pumping blood to the body after its return from oxygenation by the lungs; in some kinds of heart disease, the LV wall becomes abnormally thick. However, athletic training also produces changes in LV wall thickness that can be hard to distinguish from pathological alterations. In cases of sudden death of athletes, hypertrophic cardiomyopathy (thickening of LV walls and valves) is the most common probable cause, but more data are needed to determine the upper limits of normal LV changes in athletes. To this end, 947 competitive athletes in Italy were studied. The subjects, aged 13 to 49, were part of the group from which Olympic athletes were selected over a two-year period. They participated in soccer, rowing, cycling, track, and other events. Subjects underwent echocardiography (a noninvasive test) to determine LV wall thickness during diastole (the resting phase of heart action); other parameters, including LV mass, were also evaluated. Of interest was the extent of overlap between LV measurements in this group and similar measurements in people diagnosed with hypertrophic cardiomyopathy. Results showed that the LV end-diastolic dimensions (at the end of diastole) fell between 40 and 66 millimeters. The normal value in a nonathletic population is 54 millimeters or less, a level exceeded in 38 percent (363) of these athletes. Sixteen athletes had LV thickness equal to or greater than 13 millimeters (the usual cutoff point for hypertrophic cardiomyopathy). All were men; fifteen were rowers or canoeists. Most of their other cardiac dimensions also fell outside the normal range, but functional measurements (left ventricular filling with blood during diastole) were normal. Seven had abnormalities in their electrocardiograms. These 16 were particularly successful at their sports: eight had received medals. LV wall thickness among the 209 women studied was never greater than 11 millimeters. The greatest LV wall thickness, even among these athletes, was 16 millimeters, which can be taken as a normal upper limit among such a population. These data should be useful for diagnosing cardiac changes among athletes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Physiological aspects, Diseases, Heart ventricle, Left, Left heart ventricle, Athletes, Cardiomyopathy, Myocardial diseases

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Glycogen storage diseases presenting as hypertrophic cardiomyopathy

Article Abstract:

Hypertrophic cardiomyopathy, an autosomal dominant disorder associated with increased morbidity and premature mortality, is diagnosed on the basis of increased cardiac mass with histopathological findings of myocyte enlargement, myocyte disarray and cardiac fibrosis. The glycogen-storage cardiomyopathy produced by lysosome-associated membrane protein 2 (LAMP2) or protein kinase gama 2 (PRKAG2) mutations also resembles hypertrophic cardiomyopathy.

United Kingdom, Risk factors, Glycogenosis, Glycogen storage diseases

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