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Published in: The International Journal of Cardiovascular Imaging 3/2017

01-03-2017 | Original Paper

Normal values of regional left ventricular myocardial thickness, mass and distribution-assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study

Authors: Louise Hindsø, Andreas Fuchs, Jørgen Tobias Kühl, Emma Julia P. Nilsson, Per Ejlstrup Sigvardsen, Lars Køber, Børge G. Nordestgaard, Klaus Fuglsang Kofoed

Published in: The International Journal of Cardiovascular Imaging | Issue 3/2017

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Abstract

Left ventricular (LV) hypertrophy is associated with cardiovascular complications and the geometry is important for prognosis. In some cardiovascular diseases, myocardial hypertrophy or dilation occurs regionally without modifying the global size of the heart. It is therefore relevant to determine regional normal reference values of the left ventricle. The aim of this study was to derive reference values of regional LV myocardial thickness (LVMT) and mass (LVMM) from a healthy study group of the general population using cardiac computed tomography angiography (CCTA). We wanted to introduce LV myocardial distribution (LVMD) as a measure of regional variation of the LVMT. Moreover, we wanted to determine whether these parameters varied between men and women. We studied 568 (181 men; 32%) adults, free of cardiovascular disease and risk factors, who underwent 320-detector CCTA. Mean age was 55 (range 40–84) years. Regional LVMT and LVMM were measured, according to the American Heart Association’s 17 segment model, using semi-automatic software. Mean LVMT were 6.6 mm for men and 5.4 mm for women (p < 0.001). The normal LV was thickest in the basal septum (segment 3; men = 8.3 mm; women = 7.2 mm) and thinnest in the mid-ventricular anterior wall (segment 7; men = 5.6 mm; women = 4.5 mm) for both men and women. However, the regional LVMD differed between men and women, with the LV being most heterogenic in women. The normal human LV is morphologically heterogenic, and showed same overall pattern but different regional distribution for men and women. This study introduces LVMD and provides gender specific reference values for regional LVMT, LVMM, and LVMD.
Literature
1.
go back to reference Baltabaeva A, Marciniak M, Bijnens B et al (2008) Regional left ventricular deformation and geometry analysis provides insights in myocardial remodelling in mild to moderate hypertension. Eur J Echocardiogr 9:501–508PubMed Baltabaeva A, Marciniak M, Bijnens B et al (2008) Regional left ventricular deformation and geometry analysis provides insights in myocardial remodelling in mild to moderate hypertension. Eur J Echocardiogr 9:501–508PubMed
2.
go back to reference Florea VG, Mareyev VY, Samko AN et al (1999) Left ventricular remodelling: common process in patients with different primary myocardial disorders. Int J Cardiol 68:281–287CrossRefPubMed Florea VG, Mareyev VY, Samko AN et al (1999) Left ventricular remodelling: common process in patients with different primary myocardial disorders. Int J Cardiol 68:281–287CrossRefPubMed
3.
go back to reference Kaplinsky E (1994) Significance of left ventricular hypertrophy in cardiovascular morbidity and mortality. Cardiovasc Drugs Ther 8(Suppl 3):549–556CrossRefPubMed Kaplinsky E (1994) Significance of left ventricular hypertrophy in cardiovascular morbidity and mortality. Cardiovasc Drugs Ther 8(Suppl 3):549–556CrossRefPubMed
4.
go back to reference Levy D, Garrison RJ, Savage DD et al (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566CrossRefPubMed Levy D, Garrison RJ, Savage DD et al (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566CrossRefPubMed
5.
go back to reference Bang CN, Gerdts E, Aurigemma GP et al (2014) Four-group classification of left ventricular hypertrophy based on ventricular concentricity and dilatation identifies a low-risk subset of eccentric hypertrophy in hypertensive patients. Circ Cardiovasc Imaging 7:422–429CrossRefPubMed Bang CN, Gerdts E, Aurigemma GP et al (2014) Four-group classification of left ventricular hypertrophy based on ventricular concentricity and dilatation identifies a low-risk subset of eccentric hypertrophy in hypertensive patients. Circ Cardiovasc Imaging 7:422–429CrossRefPubMed
6.
go back to reference Koren MJ, Devereux RB, Casale PN et al (1991) Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114:345–352CrossRefPubMed Koren MJ, Devereux RB, Casale PN et al (1991) Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114:345–352CrossRefPubMed
7.
go back to reference Verma A, Meris A, Skali H et al (2008) Prognostic implications of left ventricular mass and geometry following myocardial infarction: the VALIANT (VALsartan In Acute myocardial iNfarcTion) echocardiographic study. JACC Cardiovasc Imaging 1:582–591CrossRefPubMed Verma A, Meris A, Skali H et al (2008) Prognostic implications of left ventricular mass and geometry following myocardial infarction: the VALIANT (VALsartan In Acute myocardial iNfarcTion) echocardiographic study. JACC Cardiovasc Imaging 1:582–591CrossRefPubMed
8.
go back to reference Verdecchia P, Porcellati C, Zampi I et al (1994) Asymmetric left ventricular remodeling due to isolated septal thickening in patients with systemic hypertension and normal left ventricular masses. Am J Cardiol 73:247–252CrossRefPubMed Verdecchia P, Porcellati C, Zampi I et al (1994) Asymmetric left ventricular remodeling due to isolated septal thickening in patients with systemic hypertension and normal left ventricular masses. Am J Cardiol 73:247–252CrossRefPubMed
9.
go back to reference Tuseth N, Cramariuc D, Rieck ÅE et al (2010) Asymmetric septal hypertrophy—a marker of hypertension in aortic stenosis (a SEAS substudy). Blood Press 19:140–144CrossRefPubMed Tuseth N, Cramariuc D, Rieck ÅE et al (2010) Asymmetric septal hypertrophy—a marker of hypertension in aortic stenosis (a SEAS substudy). Blood Press 19:140–144CrossRefPubMed
10.
go back to reference Safar ME, Lehner JP, Vincent MI et al (1979) Echocardiographic dimensions in borderline and sustained hypertension. Am J Cardiol 44:930–935CrossRefPubMed Safar ME, Lehner JP, Vincent MI et al (1979) Echocardiographic dimensions in borderline and sustained hypertension. Am J Cardiol 44:930–935CrossRefPubMed
11.
go back to reference Henry WL, Clark CE, Epstein SE (1973) Asymmetric septal hypertrophy. Echocardiographic identification of the pathognomonic anatomic abnormality of IHSS. Circulation 47:225–233CrossRefPubMed Henry WL, Clark CE, Epstein SE (1973) Asymmetric septal hypertrophy. Echocardiographic identification of the pathognomonic anatomic abnormality of IHSS. Circulation 47:225–233CrossRefPubMed
12.
go back to reference Ganau A, Devereux RB, Roman MJ et al (1992) Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol 19:1550–1558CrossRefPubMed Ganau A, Devereux RB, Roman MJ et al (1992) Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol 19:1550–1558CrossRefPubMed
13.
go back to reference Kawel N, Turkbey EB, Carr JJ et al (2012) Normal left ventricular myocardial thickness for middle-aged and older subjects with steady-state free precession cardiac magnetic resonance: the multi-ethnic study of atherosclerosis. Circ Cardiovasc Imaging 5:500–508CrossRefPubMedPubMedCentral Kawel N, Turkbey EB, Carr JJ et al (2012) Normal left ventricular myocardial thickness for middle-aged and older subjects with steady-state free precession cardiac magnetic resonance: the multi-ethnic study of atherosclerosis. Circ Cardiovasc Imaging 5:500–508CrossRefPubMedPubMedCentral
14.
go back to reference Cury RC (2015) President’s page: Worldwide expansion of cardiac CT–an impressive growth in recent years. J Cardiovasc Comput Tomogr 9:77–79CrossRefPubMed Cury RC (2015) President’s page: Worldwide expansion of cardiac CT–an impressive growth in recent years. J Cardiovasc Comput Tomogr 9:77–79CrossRefPubMed
15.
go back to reference Fuchs A, Kühl JT, Lønborg J et al (2012) Automated assessment of heart chamber volumes and function in patients with previous myocardial infarction using multidetector computed tomography. J Cardiovasc Comput Tomogr 6:325–334CrossRefPubMed Fuchs A, Kühl JT, Lønborg J et al (2012) Automated assessment of heart chamber volumes and function in patients with previous myocardial infarction using multidetector computed tomography. J Cardiovasc Comput Tomogr 6:325–334CrossRefPubMed
16.
go back to reference Fuchs A, Mejdahl MR, Kühl JT et al (2016) Normal values of left ventricular mass and cardiac chamber volumes assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study. Eur Heart J Cardiovasc Imaging 17:1009–1017 Fuchs A, Mejdahl MR, Kühl JT et al (2016) Normal values of left ventricular mass and cardiac chamber volumes assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study. Eur Heart J Cardiovasc Imaging 17:1009–1017
17.
go back to reference Nordestgaard BG, Palmer TM, Benn M et al (2012) The effect of elevated body mass index on ischemic heart disease risk: causal estimates from a Mendelian randomisation approach. PLoS Med 9:e1001212CrossRefPubMedPubMedCentral Nordestgaard BG, Palmer TM, Benn M et al (2012) The effect of elevated body mass index on ischemic heart disease risk: causal estimates from a Mendelian randomisation approach. PLoS Med 9:e1001212CrossRefPubMedPubMedCentral
18.
go back to reference Levy D, Savage DD, Garrison RJ et al (1987) Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 59:956–960CrossRefPubMed Levy D, Savage DD, Garrison RJ et al (1987) Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 59:956–960CrossRefPubMed
19.
go back to reference Mancia G, Fagard R, Narkiewicz K et al (2014) 2013 ESH/ESC practice guidelines for the management of arterial hypertension. Blood Press 23:3–16CrossRefPubMed Mancia G, Fagard R, Narkiewicz K et al (2014) 2013 ESH/ESC practice guidelines for the management of arterial hypertension. Blood Press 23:3–16CrossRefPubMed
20.
go back to reference Perk J, De Backer G, Gohlke H et al (2012) European guidelines on cardiovascular disease prevention in clinical practice (version 2012): the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Int J Behav Med 19:403–488CrossRefPubMed Perk J, De Backer G, Gohlke H et al (2012) European guidelines on cardiovascular disease prevention in clinical practice (version 2012): the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Int J Behav Med 19:403–488CrossRefPubMed
21.
go back to reference Fabian J, Epstein EJ, Coulshed N (1972) Duration of phases of left ventricular systole using indirect methods. I. Normal subjects. Br Heart J 34:874–881CrossRefPubMedPubMedCentral Fabian J, Epstein EJ, Coulshed N (1972) Duration of phases of left ventricular systole using indirect methods. I. Normal subjects. Br Heart J 34:874–881CrossRefPubMedPubMedCentral
22.
go back to reference Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542CrossRefPubMed Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542CrossRefPubMed
23.
go back to reference Masshoff W, Scheidt D, Reimers HF (1967) Virchows Archiv Für Pathologische Anatomie Und Physiologie Und Für Klinische Medizin. Virchows Arch Pathol Anat Physiol. Klin Med 342:184–189 Masshoff W, Scheidt D, Reimers HF (1967) Virchows Archiv Für Pathologische Anatomie Und Physiologie Und Für Klinische Medizin. Virchows Arch Pathol Anat Physiol. Klin Med 342:184–189
24.
go back to reference Lang RM, Bierig M, Devereux RB et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108CrossRefPubMed Lang RM, Bierig M, Devereux RB et al (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7:79–108CrossRefPubMed
25.
go back to reference Bogaert J, Rademakers FE (2001) Regional nonuniformity of normal adult human left ventricle. Am J Physiol Heart Circ Physiol 280:H610–H620PubMed Bogaert J, Rademakers FE (2001) Regional nonuniformity of normal adult human left ventricle. Am J Physiol Heart Circ Physiol 280:H610–H620PubMed
26.
go back to reference Stolzmann P, Scheffel H, Leschka S et al (2008) Reference values for quantitative left ventricular and left atrial measurements in cardiac computed tomography. Eur Radiol 18:1625–1634CrossRefPubMed Stolzmann P, Scheffel H, Leschka S et al (2008) Reference values for quantitative left ventricular and left atrial measurements in cardiac computed tomography. Eur Radiol 18:1625–1634CrossRefPubMed
27.
go back to reference Dannenberg AL, Levy D, Garrison RJ (1989) Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol 64:1066–1068CrossRefPubMed Dannenberg AL, Levy D, Garrison RJ (1989) Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol 64:1066–1068CrossRefPubMed
28.
go back to reference Yeon SB, Salton CJ, Gona P et al (2015) Impact of age, sex, and indexation method on MR left ventricular reference values in the Framingham Heart Study offspring cohort. J Magn Reson Imaging 41:1038–1045CrossRefPubMed Yeon SB, Salton CJ, Gona P et al (2015) Impact of age, sex, and indexation method on MR left ventricular reference values in the Framingham Heart Study offspring cohort. J Magn Reson Imaging 41:1038–1045CrossRefPubMed
29.
go back to reference Cain PA, Ahl R, Hedstrom E et al (2007) Physiological determinants of the variation in left ventricular mass from early adolescence to late adulthood in healthy subjects. Clin Physiol Funct Imaging 27:255–262CrossRefPubMed Cain PA, Ahl R, Hedstrom E et al (2007) Physiological determinants of the variation in left ventricular mass from early adolescence to late adulthood in healthy subjects. Clin Physiol Funct Imaging 27:255–262CrossRefPubMed
30.
go back to reference Payne JR, James LE, Eleftheriou KI et al (2007) The association of left ventricular mass with blood pressure, cigarette smoking and alcohol consumption; data from the LARGE Heart study. Int J Cardiol 120:52–58CrossRefPubMed Payne JR, James LE, Eleftheriou KI et al (2007) The association of left ventricular mass with blood pressure, cigarette smoking and alcohol consumption; data from the LARGE Heart study. Int J Cardiol 120:52–58CrossRefPubMed
31.
go back to reference Bischoff B, Hein F, Meyer T et al (2009) Trends in radiation protection in CT: present and future status. J Cardiovasc Comput Tomogr 3(Suppl 2):S65–S73CrossRefPubMed Bischoff B, Hein F, Meyer T et al (2009) Trends in radiation protection in CT: present and future status. J Cardiovasc Comput Tomogr 3(Suppl 2):S65–S73CrossRefPubMed
Metadata
Title
Normal values of regional left ventricular myocardial thickness, mass and distribution-assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study
Authors
Louise Hindsø
Andreas Fuchs
Jørgen Tobias Kühl
Emma Julia P. Nilsson
Per Ejlstrup Sigvardsen
Lars Køber
Børge G. Nordestgaard
Klaus Fuglsang Kofoed
Publication date
01-03-2017
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging / Issue 3/2017
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-1015-9

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