Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There is increasing interest in the notion that some patients with hypertrophic cardiomyopathy (HCM) progress to morphological and functional manifestations similar to those of dilated cardiomyopathy (DCM). From 165 consecutive patients with HCM, 20 patients with left ventricular dilatation (left ventricular end-diastolic diameter greater than or equal to 50 mm) were selected and designated as dilated HCM. The diagnosis of HCM was established in these patients either by detection of the classical form of HCM in family members, with 2-dimensional echocardiographic evidence of asymmetric septal hypertrophy (ASH; septal thickness greater than or equal to 15 mm and a ratio of septal to posterior wall thickness greater than or equal to 1.3); or by demonstrating myocardial fiber disarray in autopsy or biopsy samples. The clinical manifestations of these patients with dilated HCM were then compared with those of other forms of HCM without left ventricular dilatation; 1) 40 patients with hypertrophic obstructive cardiomyopathy (HOCM) who had resting intraventricular pressure gradients of 20 mmHg or more, 2) 80 patients with non-obstructive HCM, each of whom had ASH of the entire ventricular septum (typical ASH), and 3) 25 non-obstructive patients whose hypertrophy was localized to the apical region of the ventricular septum (apical ASH). Patients having apical hypertrophy with a spade-like configuration on the left ventriculogram were excluded from the study. Compared with HOCM and typical ASH groups, the patients with dilated HCM had family histories of significantly more frequent HCM and less frequent hypertension. The patients with dilated HCM also had significantly less fractional shortening (FS), decreased interventricular septal thickness, greater left ventricular end-diastolic pressure (LVEDP), and left ventricular dilatation. During the follow-up period (average: 3.5 years), seven patients (35%) with dilated HCM died; five from congestive heart failure (CHF), one suddenly, and one three days following mitral valve replacement. The other five patients had CHF at the time of their follow-up examination. The patients with apical ASH had clinical features similar to those of dilated HCM; a higher familial frequency, less marked septal hypertrophy, and higher LVEDP. They tended to develop left ventricular dilatation, associated with reduced fractional shortening, although left ventricular diameter at end-diastole did not exceed 50 mm. These findings suggested that dilated HCM is not a rare condition. It is observed in 12% of consecutive patients with HCM.(ABSTRACT TRUNCATED AT 400 WORDS)
J Cardiol 1988 Jun
PMID:[Hypertrophic cardiomyopathy with left ventricular dilatation]. 324 61

The clinical course of hypertrophic cardiomyopathy with left ventricular outflow obstruction showed a symptomatic progression in 25% of patients, independent of the of degree of left ventricular obstruction. Echocardiographic and mechanocardiographic examinations showed a close relationship between severity of asymmetric ventricular hypertrophy and diastolic failure. During the follow-up septal hypertrophy became more severe without left ventricular dilatation. Global diastolic function deteriorated and the left atrium dilated. The probability of survival was 67.2%. Our data suggest that septum hypertrophy and diastolic dysfunction are progressive in HOCM. The mortality is independent of the severity of hypertrophy and diastolic dysfunction, and shows a close correlation with arrhythmias.
Acta Cardiol 1988
PMID:Noninvasive follow-up study in hypertrophic obstructive cardiomyopathy. 326 Oct 89

To investigate the pathogenesis and pathophysiology of dilated cardiomyopathy (DCM), we studied 28 patients with DCM by echocardiography and endomyocardial biopsy, and compared their findings with those of 34 patients including eight with myocarditis, seven with alcoholics, 12 with hypertensives and seven patients with hypertrophic cardiomyopathy. All 12 patients in the hypertensive group had congestive heart failure without accompanying high blood pressure, and prominent dilatation and uniform wall motion abnormality of the left ventricle observed echocardiographically on admission. After medical management, both heart failure and the echocardiographic abnormalities gradually resolved. Those in the alcoholic group had larger left ventricles and uniform wall motion abnormality compared to those in the other groups. The myocarditis and hypertrophic cardiomyopathy groups had smaller left ventricles, non-uniform wall motion and larger % myocardial fibrosis. Both ventricles in the hypertrophic cardiomyopathy group were thicker than those of the other three groups. Each patient with DCM had individual echocardiographic abnormalities, which could be categorized as two subsets depending on the degree of left ventricular dilatation and uniformity of the wall motion. The one was characterized by a prominently dilated left ventricle and uniform wall motion abnormality similar to the alcoholic group, and the other had less marked left ventricular dilatation and heterogeneous wall motion abnormality similar to the myocarditis group. From these findings, it was suggested that there are common factors to specific myocardial disease in the pathogenesis and pathophysiology of DCM, and thus, DCM might include many subsets of different etiologies.
J Cardiol 1987 Mar
PMID:[Pathogenesis of dilated cardiomyopathy: a study based on comparison of the clinical features with other related conditions]. 342 22

To evaluate the evolution of mitral valve prolapse (MVP) with increasing age, 158 patients were studied by two-dimensional echocardiography and 24-hour ambulatory electrocardiography (Holter monitoring). The patients were divided into seven age groups (25 patients ranging in age from 12 to 14 years, 21 from 15 to 17, 24 from 18 to 20, 24 from 21 to 30, 37 from 31 to 50, 8 from 51 to 60 and 19 older than 61). Each patient was echocardiographically graded as mild, moderate and severe MVP. Ventricular arrhythmia by Holter monitoring was graded as I, II, III and IV according to Lown et al. The following results were obtained. 1. Incidence of moderate and severe MVP was less than 10% in patients younger than 20 years, but increased with age. Incidence of left ventricular dilatation (left ventricular end-diastolic dimension less than or equal to 55 mm) and left atrial dilatation (left atrial dimension greater than or equal to 40 mm) were minimal in patients younger than 20 years, but increased with age, especially in patients older than 51 years. 2. Ventricular couplets or triplets (Lown grade IV) were found in less than 10% in patients in age from 15 to 17 years, 33% in patients from 18 to 20 years and showed no increase with age. The rate of ventricular tachycardia was over 150 beat per min (bpm) in five of nine patients (56%), and the sinus rate preceding ventricular tachycardia was from 65 to 140 bpm.
J Cardiol Suppl 1987
PMID:[Natural history of mitral valve prolapse with respect to the heart size and ventricular arrhythmias]. 350 31

The mother and three children of a family whose parents were consanguineous, each had cardiomyopathy with various patterns of hypertrophy and dilatation. All members had asymmetrical septal hypertrophy (ASH), and three of them were characterized as hypertrophic cardiomyopathy (HCM). Another one had ventricular dilatation mimicking dilated cardiomyopathy (DCM). Case 1: The 57-year-old mother had a typical ASH pattern; her septal/posterior wall thickness ratio (IVST/LVPWT) was 2.5. Case 2: The 37-year-old daughter had basal septal hypertrophy. Case 3: The 32-year-old elder son had typical concentric hypertrophy. Case 4: The 30-year-old younger son had an episode of congestive heart failure, and showed DCM-like features with considerable dilatation and impaired wall motion of the left ventricle. The hypertrophic pattern in cardiomyopathies is thought to depend partially on the ages of the onset, or its evolution with aging.
J Cardiol 1987 Dec
PMID:[Familial cardiomyopathy with different clinical features in individual members]. 350 15

A 40-year-old man was admitted to our hospital in May 1982 for evaluation of a heart murmur. A standard 12-lead electrocardiogram (ECG) showed an abnormal Q wave in lead III. Echocardiography revealed prolapse of the anterior mitral valve leaflet (MVP), but neither dilatation nor wall motion abnormalities of the left ventricle (LV) were observed. Thallium-201 scintigraphy revealed an abnormal thallium uptake at the apex and inferior wall. He had no episode of acute myocardial infarction or myocarditis, but complete right bundle branch block suddenly appeared, and he was hospitalized in October 1984. He had no coronary artery lesions, and only mild mitral regurgitation on left ventriculography. The motion of the interventricular septum and apex was reduced on echocardiography and a persistent perfusion defect was observed at the inferior wall and the interventricular septum on T1-201 scintigraphy. In December 1985, he experienced an Adams-Stokes attack due to complete atrioventricular block. Echocardiographically, the left ventricle became enlarged and the wall motion abnormality and a perfusion defect on T1-201 scintigrams were of relatively severe degree. Thus, left ventricular dilatation and wall motion abnormality may progress in some cases of MVP as it did in this one. We consider this case a very interesting one in speculating on the relationship between MVP and DCM.
J Cardiol 1987 Dec
PMID:[Regression of mitral valve prolapse to a state masquerading as dilated cardiomyopathy: a case report]. 350 16

Mitral regurgitation (MR) is common in patients with congestive heart failure (CHF), but the frequency in relation to the origin of ventricular dilatation has not been established. In 50 patients referred for cardiac transplantation, MR was assessed by Doppler echocardiography and the findings were compared with clinical information. Dilatation of the left ventricle, left atrium and mitral anulus was analyzed in 25 patients with respect to cause of CHF. All 50 patients had MR of at least moderate severity, regardless of cause (idiopathic dilated cardiomyopathy in 36, coronary artery disease in 14), length of symptoms (20 +/- 19 months, less than 6 months in 13 patients) or presence of murmurs (absent in 13 patients). Comparison of patients with nonischemic cardiomyopathy to those with ischemic heart disease revealed larger left ventricular volumes (215 +/- 81 vs 131 +/- 60 ml in systole, p less than 0.05) and left atrial volumes (124 +/- 70 vs 70 +/- 35 ml, p less than 0.05). Mitral anular dilatation was present only in patients with idiopathic cardiomyopathy (diameters 3.6 +/- 0.4 vs 3.1 +/- 0.2 cm, p less than 0.05). The frequency of significant MR in these patients with CHF suggests that it may have a major role in decompensation and in the therapeutic response.
Am J Cardiol 1987 Apr 01
PMID:Predictability of mitral regurgitation detected by Doppler echocardiography in patients referred for cardiac transplantation. 354 6

To estimate the influence of left ventricular cavity dimension on the electrocardiographic estimation of the extent of wall motion abnormalities, two-dimensional echocardiograms and standard 12-lead electrocardiograms (ECG) were carried out on 221 patients within 3 months after acute myocardial infarction (MI). Among the patients with anterior MI (96 patients; 43.4%) both the extent of asynergy (% of asynergic segments, an echo index taking into account the type of asynergy) and the electrocardiographic signs of necrosis (number of Q waves greater than or equal to 40 ms, Wagner's score) were significantly greater (p less than 0.001) in those with left ventricular dilatation (60 patients) than in those with normal ventricular size (36 patients); within the latter group, the ECG-asynergy correlations were good (r value 0.67-0.79). In patients with left ventricular dilatation no correlation was found. In inferior MI (108 patients, 48.9%), asynergy was more extensive in patients with left ventricular dilatation (p less than 0.001) than in those with normal left ventricle. However, the electrocardiographic extent of necrosis was similar in the two groups and no significant ECG-asynergy correlation was found. Likewise, in anteroinferior MI (17 patients; 7.7%), the ECG-asynergy correlations were statistically insignificant in both groups. In conclusion, the electrocardiographic patterns of necrosis are poorly related to the extent of asynergy and are greatly influenced by left ventricular dimensions.
Clin Cardiol 1987 Sep
PMID:Influence of left ventricular cavity dimension on electrocardiographic estimation of the extent of wall motion abnormalities. 362 1

112 consecutive asymptomatic patients who assumed alcohol in excess (1-2 g/kg/die) for 5 years or more were admitted to our hospital for detoxication. They were examined both clinically and with chest x-rays, ecg, phonocardiography, external pulse recording, and M-mode/2-D echocardiography to detect myocardial involvement. Heart disease not related to alcohol abuse was found in 6 cases. In the remaining 106/112 patients electrocardiographic abnormalities (aspecific ST-T changes, left bundle branch block, intraventricular conduction defects, left ventricular strain pattern and atrial fibrillation) were present in 18 per cent of cases. PEP, LVET intervals and PEP/LVET, were calculated only in 39/106 patients and did not differ significantly from the control group. The echocardiographic study showed hypokinesis and left ventricular dilatation in 9/106 patients. In other 5 cases echocardiographic findings were at upper limits of normal for left ventricular dimension and motility. Therefore in 13 per cent of cases a dilated cardiomyopathy was revealed by the echocardiographic study. In 6 of these 13/106 patients ecg was either normal or showed only aspecific ST-T changes. Echocardiography failed to confirm augmented left ventricular thickness and mass as reported in asymptomatic alcoholic patients in the literature. Probably several factors (different interval of time between the interruption of the alcoholic abuse and the time of examination, the quantity of alcohol in excess and the echocardiographic technique) may influence the results of such studies. The present report nevertheless points out to the validity of the echocardiographic study in the detection of subclinical myocardial involvement in alcoholic patients and should be performed in such cases.
G Ital Cardiol 1986 Dec
PMID:[Alcoholic cardiomyopathy in the preclinical stage: non-invasive clinico-instrumental research study on 112 chronic alcoholics]. 367 28

A case of inferior myocardial infarction complicated by severe arrhythmias and right heart failure is presented. Radionuclide studies performed near the acute phase and one month later illustrate the reversibility of right heart dysfunction caused by infarction. Signs of right ventricular involvement in acute inferior myocardial infarction are noted in about 40% of cardiac blood-pool studies: right ventricular dilatation with a significantly decreased ejection fraction, and ventricular wall motion abnormalities. Follow-up studies in the recovery period show good recovery of right ventricular function.
Can J Cardiol
PMID:Spontaneous resolution of severe right ventricular dysfunction in right ventricular infarction: documentation by radionuclide studies. 384 94


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>