Left ventricular pseudohypertrophy in cardiac tamponade: An echocardiographic study in a canine model

Segni, Elio Di; Feinberg, Micha S.; Sheinowitz, Mickey; Motro, Michael; Battler, Alexander; Kaplinsky, Elieser; Vered, Zvi

doi:10.1016/0735-1097(93)90258-3

Cited by 22 publications

(11 citation statements)

References 35 publications

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“…7 A similar effect can also be seen following compression of the cardiac ventricles due to cardiac tamponade. 8 a significant decrease in left ventricular enddiastolic diameter between the first and the second echocardiographic study, which, however, cannot be explained by significant volume depletion. In contrast, tachycardia, hypotension, and a short period of preceding fluid resuscitation suggested that marked hypovolemia was present at the time of the first echocardiogram, whereas tachycardia and hypotension had resolved when the second study (i.e., time of pseudohypertrophy) was performed.…”

Section: Discussionmentioning

confidence: 78%

Transient Left Ventricular “Hypertrophy” in a Woman with Meningoencephalitis

Maeder¹,

Wölber²,

Rickli³

et al. 2006

Echocardiography

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We report the echocardiographic findings in a 27-year-old woman with viral meningoencephalitis and a positive test for cardiac troponin. Initially, the basal parts of the left ventricle were severely hypokinetic, whereas contraction in the mid-ventricle and apex was normal. A second echocardiogram obtained 19 days after the development of pulmonary edema showed a generalized, severe myocardial thickening, the left ventricular ejection fraction being normal. Three months after the initial examination the "hypertrophy" had disappeared. The serial echocardiograms along with a positive cardiac troponin led to the diagnosis of myocarditis, which can very rarely present with the echocardiographic picture of severe left ventricular thickening.

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Section: Discussionmentioning

confidence: 78%

Transient Left Ventricular “Hypertrophy” in a Woman with Meningoencephalitis

Maeder¹,

Wölber²,

Rickli³

et al. 2006

Echocardiography

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“…The left ventricle has a simple shape, rotationally symmetric around its long axis, its wall thickness is sufficient to be reproducibly measured in clinical practice, and changes in the dimensions of its cavity and wall can be easily appreciated. Initial observations in a small selected group of patients with cardiac tamponade [12], subsequently confirmed in an experimental canine model [13], demonstrated that cardiac tamponade is associated with pseudohypertrophy, transient left-ventricular ‘remodeling’ characterized by increased diastolic left-ventricular wall thickness, decreased left-ventricular dimensions and normal (unchanged) left-ventricular mass. However, whether this phenomenon strictly reflects cardiac compression or whether it results from changes in ventricular shape associated with intrapericardial fluid accumulation per se has not been systematically investigated in humans.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Pseudohypertrophy as a Measure of Left-Ventricular Compression in Patients with Cardiac Tamponade

Feinberg¹,

Popescu²,

Popescu³

et al. 2000

Cardiology

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Background: Left-ventricular pseudohypertrophy reflecting left-ventricular compression was reported in a selected group of patients with cardiac tamponade. Hypothesis: Criteria for the presence of pseudohypertrophy can be established to guide its use as a sign of left-ventricular compression in patients with cardiac tamponade. Methods: Left-ventricular wall thickness, diameters, relative diastolic wall thickness (%) = (posterior wall thickness/end diastolic radius) x 100 and estimated left-ventricular mass were measured in patients with small, moderate and large pericardial effusion, in patients with cardiac tamponade before and after pericardiocentesis (16 patients in each group) and in 30 control subjects with normal echocardiograms. Results: Left-ventricular posterior wall thickness was increased (12 ± 2 vs. 9 ± 1 mm, p < 0.001), left-ventricular end-diastolic diameter was reduced (3.9 ± 0.5 vs. 4.6 ± 0.3 cm, p < 0.001) and relative left-ventricular diastolic wall thickness was increased (61 ± 13 vs. 41 ± 4.5%, p < 0.001) only in patients with cardiac tamponade compared to controls, but not in patients with small, moderate and large effusions, respectively (relative wall thickness: 42 ± 5, 41 ± 7 and 44 ± 7%, p = NS). Mean values of the estimated left-ventricular mass were similar in all groups. Following pericardiocentesis all parameters were normal. Conclusions: Despite normal left-ventricular mass, relative left-ventricular diastolic wall thickness is elevated in patients with cardiac tamponade. In contrast it is normal in patients with various degrees of pericardial effusion supporting its use as a quantitative measure of left-ventricular compression in patients with suspected cardiac tamponade.

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“…The concept of dynamic change of LV configuration inducing pseudohypertrophy in rapid LV unloading is attractive 13,14 . Unfortunately in the orthostatic test we use only apical window for imaging focused on LVOT gradient.…”

Section: The Selection Of Stress Test To Provoke Lvotg In Hemodialyzementioning

confidence: 99%