LEFT VENTRICULAR HYPERTROPHY

Transcription

1 LEFT VENTRICULAR HYPERTROPHY WILLEM EINTHOVEN

2 Developments in Cardiovascular Medicine VOLUME 223

3 Left Ventricular Hypertrophy Physiology versus Pathology by ERNST E. VAN DER WALL ARNOUD VAN DER LAARSE BABETTE M. PLUIM and ALBERT v.g. BRUSCHKE Leiden University Medical Center, Leiden, The Netherlands,.. ~ '. ~&~. -'4i~ MSD SPRINGER-SCIENCE+BUSINESS MEDIA, B.V.

4 A C.I. P. Catalogue record for this book is available from the Library of Congress ISBN ISBN (ebook) DOI / Printed an acid-free paper AII Rights Reserved 1999 Springer Science+Business Media Dordrecht Originally published by Kluwer Academic Publishers in 1999 Softcover reprint of the hardcover 1 st edition 1999 No part of the material protected by this copyright notice may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the copyright owner.

5 TABLE OF CONTENTS Foreword vii List of Contributors IX Chapter 1 Etiology of left ventricular hypertrophy A. van der Laarse, C. Ruwhof, le.t. van Wamel, E.E. van der Wall, A.V.G. Bruschke Chapter 2 The role of vascular failure in heart failure 15 R.A. Tio, R. de Boer, D.J. van Veldhuisen, W.H. van Gilst Chapter 3 Perfusion abnormalities in the hypertrophied left ventricle: Link. between compensated hypertrophy and heart failure? 21 D.J.G.M. Duncker Chapter 4 Assessment of left ventricular hypertrophy: a comparison of electrocardiography, echocardiography and magnetic resonance imaging 43 A.I. Brees, B.M. Pluim, H.W. Vliegen, A. de Roos, H.J. Lamb, E.E. van der Wall Chapter 5 Hypertrophy and hypertension J.J. Schipperheijn 55 Chapter 6 Left ventricular hypertrophy: pathology versus physiology B.M. Pluim, A. van der Laarse, H.W. Vliegen, A.V.G. Bruschke, E. E. van der Wall 65

6 vi Chapter 7 The athlete's heart: a physiological or a pathological phenomenon? B.M. Pluim, A. van der Laarse, E.E. van der Wall 85 Chapter 8 Left ventricular hypertrophic heart disease studied by MR imaging and 31p_MR spectroscopy R.J. Lamb, A. de Roos, E.E. van der Wall 107 Chapter 9 Hypertrophy and arrhythmias A.A.M. Wilde 121 Chapter 10 Left ventricular hypertrophy: reversal by antihypertensive therapy A. van der Laarse, E.E. van der Wall 131 Chapter 11 Postoperative regression of left ventricular hypertrophy L.H.B. Baur, J. Braun, A.P. Kappetein, C.H. Peels, X.Y. Jin, Y. Houdas, E.A. van der Velde, M. Hazekamp, E.E. van der Wall, A.V.G. Bruschke, H.A. Huysmans 139 Chapter 12 Myocardial hypertrophy and failure: a molecular approach lm. van Dantzig, R. Bronsaer, P.A.F.M. Doevendans 151 Chapter 13 Hypertrophy: clinical relevance of genotype. Einthoven lecture 1999 K. Schwartz 163 Index 175

7 FOREWORD The importance of left ventricular hypertrophy in cardiovascular disease has gained wide recognition. Left ventricular hypertrophy is a highly important risk factor associated with major cardiovascular events, including symptomatic heart failure, particularly in patients with systemic hypertension. Over the past years much has been learned about the genetics, molecular background, prevalence, incidence and prognosis of left ventricular hypertrophy. A variety of noninvasive methods has emerged for detecting left ventricular hypertrophy and the assessment of reversal of hypertrophy. Yet, a lot of controversy remains about the connotations and clinical implications of left ventricular hypertrophy. For instance, in the athlete's heart left ventricular hypertrophy may constitute a physiological adaptation to pressure overload, which normalizes following discontinuation of strenuous physical activity. On the other hand, in particular in patients with hypertension, left ventricular hypertrophy denotes a serious prognosis in the course of hypertension. In these patients left ventricular hypertrophy should be regarded as a grave prognostic sign rather than an innocent compensatory phenomenon. The distinction between physiologic and pathophysiologic left ventricular hypertrophy has been the basis for this book. Basically, the interest for left ventricular hypertrophy in our institution (Leiden University Medical Center) dates back to 1992 when we received a large investment grant from NWO (Nederlands Wetenschappelijk Onderzoek, Dutch Scientific Investigation) to perform magnetic resonance imaging and spectoscopy to evaluate individuals with left ventricular hypertrophy. At that time, we decided to focus on three different groups of individuals with left ventricular hypertrophy: elite athletes, patients with hypertension, and patients with aortic valve disease. In this way approached, we tried to get an answer on the issue whether one could distinguish between physiologic and pathologic left ventricular hypertrophy. This was a large project involving both the Departments of Cardiology and Radiology of our institution, and the full-time involvement of three research fellows. The project was also supported by the Ministry of Welfare, Health and Culture (WVC), the Netherlands Heart Foundation (NHS), and the Interuniversity Cardiology Institute of The Netherlands (ICIN), the latter being an institute of the Royal Netherlands Academy of Arts and Sciences. The project, as described in the grant, was almost completed in 1998 and at that time it was decided that we would organize a special meeting around the topic left ventricular hypertrophy. Left ventricular hypertrophy - physiology versus pathology is a bibliographical reflection of Vll

8 viii a Boerhaave Symposium held on April 9, 1999, Leiden, The Netherlands. At this symposium the major issues dealing with left ventricular hypertrophy were discussed from etiology, genetics, detection, and therapy of left ventricular hypertrophy. In particular, the book includes novel detection methods for left ventricular hypertrophy such as magnetic resonance imaging and spectroscopy. Furthermore, much attention was paid to the molecular and genetic approach of left ventricular hypertrophy. In the last chapter the clinical relevance of genotype in the context of hypertrophy is described. This chapter was composed by Prof.dr. K. Schwartz, who gave the illustrious Einthoven Lecture 1999 at the end of the symposium. The Einthoven Lecture is named after Willem Einthoven, who was awarded the Nobel Prize in 1924 for inventing the electrocardiogram. Every two years the prestigious Einthoven Lecture is presented at our university by a well-known national or international expert in the field of cardiovascular diseases. The publication of the book would not have been possible without a generous educational grant from Merck, Sharp and Dohme (Haarlem, The Netherlands). We like to acknowledge the efforts of the authors, all of whom have written dedicated and well-focused chapters. We also like to thank the Boerhaave Committee (Mrs. L. Zitter) who put a lot of effort in preparation of the manuscript, and gave permission to publish this book. Lastly, we are grateful for the support by Mrs. Amber Tanghe-Neely (Kluwer Academic Publishers, Dordrecht) for proper guiding of the book preparation, and Mr. Jan Schoones (Leiden Medical Library) who checked all the chapter references and took care of the Index. We hope that our book will assist the clinical cardiologist, the fellows in cardiology, the general internist, the radiologist, the cardiothoracic surgeon, the biochemist, the physiologist, the pharmacologist, and the basic research fellow, in understanding the most recent insights in the background of physiologic versus pathologic left ventricular hypertrophy. The Editors Ernst E. van der Wall Arnoud van der Laarse Babette M. P1uim Albert V.G. Bruschke

9 LIST OF CONTRIBUTORS L.H.B. Baur Department of Cardiology, Leiden University Medical Center Albinusdreef2, P.O. Box 9600, 2300 RC Leiden, The Netherlands Co-authors: A.V.G. Bruschke, 1. Braun, M. Hazekamp, Y. Houdas, H.A.Huysmans X.Y. Jin, A.P. Kappetein, C.H. Peels, E.A. van der Velde, E.E. van der Wall A.J. Brees Department of Cardiology, Leiden University Medical Center Albinusdreef2, P.O. Box 9600, 2300 RC Leiden, The Netherlands Co-authors: B.M.Pluim, H. Lamb, A. de Roos, H.W. Vliegen, E.E. van der Wall P.A.F.M. Doevendans Department of Cardiology, Academic Hospital Maastricht P. Debyelaan 25,6202 AZ Maastricht, The Netherlands Co-authors: R. Bronsaer, J.M. van Dantzig D.G.J.M. Duncker Department of Experimental Cardiology, Erasmus University Rotterdam P.O. Box 1738, 3000 DR Rotterdam, The Netherlands A. van der Laarse Department of Cardiology, Leiden University Medical Center Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, The Netherlands Co-authors: A.V.G. Bruschke, C. Ruwhof, E.B. van der Wall, J.E.T. van Wamel H. J. Lamb Department of Radiology, Leiden University Medical Center Albinusdreef2, P.O. Box 9600, 2300 RC Leiden, The Netherlands Co-authors: A. de Roos, E.E. van der Wall ix

10 x B.M. Pluim Royal Netherlands Lawn Tennis Association, Sports Medical Center Papendal, Papendallaan 60,6816 VD Arnhem, The Netherlands Co-authors: A.V.G. Bruschke, A. van der Laarse, H.W. Vliegen, E.E. van der Wall J.J. Schipperheijn Department of Cardiology, Leiden University Medical Center Albinusdreef2, P.O. Box 9600, 2300 RC Leiden, The Netherlands K. Schwartz, Directeur de Recherce lnsermfcnrs lnserm, U 153,47, Boulevard de I'Hopital, Paris Cedex 13, France R.A. Tio Department of Clinical Pharmacology, University Groningen Ant. Deusinglaan 1,9713 AV Groningen, The Netherlands Co-authors: R. de Boer, W.H. van Gilst, DJ. van Veldhuisen A.A.M. Wilde Department of Cardiology, Amsterdam Medical Center Meibergdreef9, 1105 AZ Amsterdam, The Netherlands