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Refined 4‐group classification of left ventricular hypertrophy based on ventricular concentricity and volume dilatation outlines distinct noninvasive hemodynamic profiles in a large contemporary echocardiographic population
Author(s) -
Barbieri Andrea,
Rossi Andrea,
Gaibazzi Nicola,
Erlicher Andrea,
Mureddu Gian Francesco,
Frattini Silvia,
Faden Giacomo,
Manicardi Marcella,
Beraldi Monica,
Agostini Francesco,
Lazzarini Valentina,
Moreo Antonella,
Temporelli Pier Luigi,
Faggiano Pompilio
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14031
Subject(s) - cardiology , hemodynamics , medicine , left ventricular hypertrophy , volume (thermodynamics) , population , muscle hypertrophy , blood pressure , physics , environmental health , quantum mechanics
Background Left ventricular hypertrophy (LVH) may reflect a wide variety of physiologic and pathologic conditions. Thus, it can be misleading to consider all LVH to be homogenous or similar. Refined 4‐group classification of LVH based on ventricular concentricity and dilatation may be identified. To determine whether the 4‐group classification of LVH identified distinct phenotypes, we compared their association with various noninvasive markers of cardiac stress. Methods Cohort of unselected adult outpatients referred to a seven tertiary care echocardiographic laboratory for any indication in a 2‐week period. We evaluated the LV geometric patterns using validated echocardiographic indexation methods and partition values. Results Standard echocardiography was performed in 1137 consecutive subjects, and LVH was found in 42%. The newly proposed 4‐group classification of LVH was applicable in 88% of patients. The most common pattern resulted in concentric LVH (19%). The worst functional and hemodynamic profile was associated with eccentric LVH and those with mixed LVH had a higher prevalence of reduced EF than those with concentric LVH ( P < .001 for all). Conclusions The new 4‐group classification of LVH system showed distinct differences in cardiac function and noninvasive hemodynamics allowing clinicians to distinguish different LV hemodynamic stress adaptations in patients with LVH.