Hypertrophy
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Left ventricular hypertrophy may be a consequence of a hemodynamic overload or a manifestation of several diseases affecting different structural and functional proteins of cardiomyocytes. Among these, sarcomeric hypertrophic cardiomyopathy (HCM) represents the most frequent cause. In addition, several metabolic diseases lead to myocardial thickening, either due to intracellular storage (glycogen storage and lysosomal diseases), extracellular deposition (TTR and AL amyloidosis) or due to abnormal energy metabolism (mitochondrial diseases). The recognition of these rare causes of myocardial hypertrophy is important for family screening strategies, risk assessment, and treatment. Moreover, as there are specific therapies for some forms of HCM including enzyme substitution and chaperone therapies and specific treatments for TTR amyloidosis, a differential diagnosis should be sought in all patients with unexplained left ventricular hypertrophy. Diastolic dysfunction is a key feature of HCM and its phenocopies. Its assessment is complex and requires evaluation of several functional parameters and structural changes. Severe diastolic dysfunction carries a negative prognostic implication and its value in differential diagnosis is limited.
- Klíčová slova
- Amyloidosis, Anderson Fabry disease, Danon disease, Hypertrophic cardiomyopathy, Left ventricular hypertrophy, Myocardial storage,
- MeSH
- amyloidóza diagnostické zobrazování epidemiologie patofyziologie MeSH
- dysfunkce levé srdeční komory diagnostické zobrazování epidemiologie patofyziologie MeSH
- hypertrofická kardiomyopatie diagnostické zobrazování epidemiologie patofyziologie MeSH
- hypertrofie levé komory srdeční diagnostické zobrazování epidemiologie patofyziologie MeSH
- lidé MeSH
- vzácné nemoci diagnostické zobrazování epidemiologie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Masticatory muscle hypertrophy (MMH) is a rare clinical phenomenon of uncertain etiology, characterized by a soft swelling near the angle of the jaw. This abnormal enlargement of the masseter muscle can alter the facial profile, leading to aesthetic concerns. Moreover, MMH may also have significant functional repercussions, including pain in the masseter region, often associated with temporomandibular disorders, fatigue, and discomfort during mastication. Non-conservative approaches offer an effective and minimally invasive solution by inducing localized muscle relaxation and reducing hypertrophy. Botulinum neurotoxin type A (BoNT/A) represents a therapeutic option for managing MMH, considering that injections can effectively reduce the masseter muscle volume, improving both facial aesthetics and related symptoms. Currently, the standard non-surgical management of MMH is BoNT/A injections, although consensus on the average dosage has not been definitely reached; on the other hand, there are data available in the literature about the injection technique of BoNT/A for lower face contouring. Therefore, the present comprehensive review aimed at exploring in detail the role of BoNT/A in the treatment of masseter muscle hypertrophy, describing its mechanism of action, the administration protocols, the clinical effects, and any side effects.
- Klíčová slova
- botulinum toxin type A, lower face contouring, masseter muscle hypertrophy,
- MeSH
- botulotoxiny typu A * terapeutické užití škodlivé účinky aplikace a dávkování MeSH
- hypertrofie * farmakoterapie MeSH
- lidé MeSH
- musculus masseter * účinky léků patologie abnormality MeSH
- nervosvalové látky * terapeutické užití škodlivé účinky MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- botulotoxiny typu A * MeSH
- nervosvalové látky * MeSH
BACKGROUND: In hemodialysis patients, left ventricular hypertrophy (LVH) contributes to high cardiovascular mortality. We examined cardiovascular mortality prediction by the recently proposed Peguero-Lo Presti voltage since it identifies more patients with electrocardiographic (ECG) LVH than Cornell or Sokolow-Lyon voltages. METHODS: A total of 308 patients on hemodialysis underwent 24 h ECG recordings. LVH parameters were measured before and after dialysis. The primary endpoint of cardiovascular mortality was recorded during a median 3-year follow up. Risk prediction was assessed by Cox regression, both unadjusted and adjusted for the Charlson Comorbidity Index and the Cardiovascular Mortality Risk Score. RESULTS: The Peguero-Lo Presti voltage identified with 21% the most patients with positive LVH criteria. All voltages significantly increased during dialysis. Factors such as ultrafiltration rate, Kt/V, body mass index, sex, and phosphate were the most relevant for these changes. During follow-up, 26 cardiovascular deaths occurred. Post-dialysis Peguero-Lo Presti cut-off as well as the Peguero-Lo Presti and Cornell voltages were independently associated with cardiovascular mortality in unadjusted and adjusted analysis. The Sokolow-Lyon voltage was not significantly associated with mortality. An optimal cut-off for the prediction of cardiovascular mortality was estimated at 1.38 mV for the Peguero-Lo Presti. CONCLUSIONS: The post-dialysis Peguero-Lo Presti cut-off as well as the Peguero-Lo Presti and Cornell voltages allowed independent risk prediction of cardiovascular mortality in hemodialysis patients. Measuring the ECG LVH parameters after dialysis might allow a standardized interpretation as dialysis-specific factors influence the voltages.
- Klíčová slova
- Cardiovascular mortality, Hemodialysis, Left ventricular hypertrophy, Peguero-Lo presti,
- MeSH
- dialýza ledvin škodlivé účinky MeSH
- elektrokardiografie MeSH
- hypertenze * MeSH
- hypertrofie levé komory srdeční * diagnóza etiologie MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Masseter hypertrophy (MH) is an uncommon natural condition that affects the facial contour. The etiology is debatable, and complaints are usually cosmetic in nature. The diagnosis is essentially clinical and aided by imaging tests. Treatment is still controversial. The literature is relatively scarce in relation to information on MH, particularly in the evaluation of outcomes. Through questionnaires, the progress was observed in the evaluation of the outcomes of aesthetic procedures. Thus, the purpose of this paper is to apply a Facelift Outcome Evaluation (FOE) questionnaire to evaluate the outcomes of surgical treatment in a case of MH. A 23-year-old male presented to the clinic complaining of bullying due to his facial aesthetics. Clinical and imaging evaluation was performed, with the creation of surgical guides. The patient answered the FOE questionnaire pre- and postoperatively, with results of 12.5 and 100.00 respectively. This subjectively shows the success of the treatment. We suggest that a questionnaire applied exclusively to masseter hypertrophy should be developed, as well as studies for the development of muscle volume measurement protocols, aiming at a more specific evaluation of the surgical outcomes.
- Klíčová slova
- Masseter muscle, Muscle hypertrophy, Myotomy,
- MeSH
- ambulantní zařízení * MeSH
- dospělí MeSH
- estetika MeSH
- hypertrofie chirurgie MeSH
- lidé MeSH
- mladý dospělý MeSH
- musculus masseter abnormality MeSH
- šikana * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
It has not been explained whether the etiological substrate of left ventricular hypertrophy has any influence on prevalence and severity of ventricular arrhythmias. Therefore, 48 h ambulatory electrocardiographic monitoring findings were compared in two groups of untreated patients without coronary artery disease and with no significant differences in age, sex, maximal and average myocardial thickness and left ventricular systolic function. Group A comprised 42 patients with pressure overload hypertrophy due to essential hypertension, and group B comprised 42 patients with hypertrophic cardiomyopathy. The prevalence of complex ventricular arrhythmias (Lown 3a-4b) was high in both groups (65% versus 60%, respectively, not significant). No significant difference was found in total frequency of most serious arrhythmias: Lown 4a, 26 versus 21 events (not significant), and Lown 4b, 20 versus 28 events (not significant). There was a correlation between prevalence of complex ventricular arrhythmias and maximal myocardial thickness in both groups of patients (P < 0.05), and, in group A only, between prevalence of complex ventricular arrhythmias and age (P < 0.01). It was concluded that, although the etiology of pressure overload hypertrophy of the left ventricle and that of hypertrophic cardiomyopathy are completely different, the overall prevalence and spectrum of ventricular arrhythmias in both types of hypertrophy are identical.
- MeSH
- dospělí MeSH
- elektrokardiografie ambulantní MeSH
- elektrokardiografie MeSH
- hypertenze komplikace MeSH
- hypertrofická kardiomyopatie komplikace diagnóza MeSH
- hypertrofie levé komory srdeční komplikace diagnóza etiologie MeSH
- komorová tachykardie diagnóza etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Labia minora hypertrophy is a congenital or acquired condition in which both labia minora (or more rarely only one) protrude beyond the edge of the labia majora. The authors present a surgical technique of volumetric reduction of hypertrophic labia minora, associated with lipofilling of the labia majora. METHODS: Between 2005 and 2014, 27 patients underwent surgical reduction of labia minora, as described by Altier and Rouzier. The indications for surgical treatment varied and were as follows: interference with sexual intercourse; poor hygiene; difficulty wearing tight-fitting pants; difficulty while performing sporting activities such as cycling; aesthetic complaints. The surgical resection was associated with fat graft injection in labia majora in order to protect and cover the labia minora. The mean follow up was 1 year. RESULTS: The labia majora, increased in volume and firmness, cover and protect the labia minora slightly hypertrophic or surgically reduced. All patients reported an improvement in comfort, aesthetic appearance, when wearing close-fitting clothes and an improvement in their sexuality. In one case we recorded a "recurrence", with an increase of dimensions in width of labia minora, still lower than the preoperative situation but greater than the immediate postop. CONCLUSIONS: The reduction of labia minora hypertrophy with conservative techniques allows achieving excellent results in terms of aesthetics and functionality. The simple lipofilling of labia majora allows preserving and protecting the labia minora through a volumetric increase of the labia majora.
- Klíčová slova
- Labia minora hypertrophy; labia minora lipofilling; labiahypertrophy treatment.,
- MeSH
- estetika MeSH
- hypertrofie MeSH
- lidé MeSH
- vulva * chirurgie MeSH
- zákroky plastické chirurgie * MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement. METHODS: We compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres. RESULTS: A total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all). CONCLUSIONS: The short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.
- Klíčová slova
- alcohol septal ablation, hypertrophic cardiomyopathy, outflow gradient, prognosis, survival,
- MeSH
- časové faktory MeSH
- dospělí MeSH
- ethanol * MeSH
- hypertrofická kardiomyopatie terapie MeSH
- hypertrofie levé komory srdeční terapie MeSH
- hypertrofie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mezikomorová přepážka patologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- ethanol * MeSH
The time course of regression of left ventricular hypertrophy and changes in left ventricular function were followed in 52 middle-aged hypertensive patients divided into two groups: 30 treated with betablockers and 22 with methyldopa. In case of inadequate blood pressure control, diuretics and/or vasodilators were added in both groups. Blood pressure decreased significantly over a three-year follow-up period. The decrease was most pronounced during the first three months. The biggest decrease in posterior wall and interventricular septum thickness was detected by echocardiography also within the first three months. While complete regression of posterior wall hypertrophy was noted within the next three months, interventricular septum thickness decreased steadily over a period of two years. No significant change was seen in the septum in the third year of follow-up. Complete regression of hypertrophy was found in 30 (57.7%) of probands, with no change altogether observed in as few as two patients. Regression was incomplete in 20 (38.4%) obese patients with manifest hypertrophy at the start of the study. Regression of hypertrophy was not associated with left ventricular function deterioration and was observed even after vasodilator administration. There were no differences between the two groups of patients.
- MeSH
- diuretika aplikace a dávkování MeSH
- echokardiografie * MeSH
- hypertenze farmakoterapie MeSH
- kardiomegalie farmakoterapie MeSH
- kombinovaná farmakoterapie MeSH
- krevní tlak účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- methyldopa aplikace a dávkování MeSH
- metipranolol aplikace a dávkování MeSH
- minutový srdeční výdej účinky léků MeSH
- následné studie MeSH
- objem srdce účinky léků MeSH
- pindolol aplikace a dávkování MeSH
- propanolaminy aplikace a dávkování MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- diuretika MeSH
- methyldopa MeSH
- metipranolol MeSH
- pindolol MeSH
- propanolaminy MeSH
Hypertrophy of the left heart ventricle as a consequence of a haemodynamic overload is a process of ambiguous biological value. Although hypertrophy allows to increase the performance of the ventricle without substantial elevation in wall tension, it represents a risk factor of cardiac morbidity and mortality. The regression of hypertrophy seems to be a rational outcome of this ambivalent situation. Not every reversal of hypertrophied muscle mass, however, can be unambiguously considered therapeutic success. The biological value of hypertrophy regression depends on the type of hypertrophy, on the level of deterioration of the heart by a long-lasting haemodynamic overload, as well as on the way in which the reversal of hypertrophy is achieved. Even in the case when functional characteristics are preserved or even improved compared to the hypertrophied heart, hypertrophy regression need not automatically mean a decrease of the cardiovascular risk induced by ventricular hypertrophy. Regression of hypertrophy may be even disadvantageous in those situations when reduction of hypertrophy and reduction of the haemodynamic overload proceed in a disproportional manner. Spontaneously developing regression of the hypertrophied left ventricle as demonstrated on the model of aortal insufficiency, is an explicitly pathological state, resulting in heart failure. Regression of myocardial hypertrophy should not be considered the primary therapeutic aim but rather a part of the management of haemodynamic overload of the heart. The main aim is to achieve optimal perfusion of the periphery, yet at the same time to provide such conditions which would prevent the working load of the heart to become a limiting factor of survival.
- MeSH
- antihypertenziva terapeutické užití MeSH
- chronická nemoc MeSH
- hemodynamika MeSH
- hypertenze farmakoterapie patofyziologie MeSH
- hypertrofie levé komory srdeční farmakoterapie metabolismus patofyziologie MeSH
- infarkt myokardu farmakoterapie patofyziologie MeSH
- lidé MeSH
- rizikové faktory MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- antihypertenziva MeSH
Exercise training-induced cardiac hypertrophy occurs following a program of aerobic endurance exercise training and it is considered as a physiologically beneficial adaptation. To investigate the underlying biology of physiological hypertrophy, we rely on robust experimental models of exercise training in laboratory animals that mimic the training response in humans. A number of experimental strategies have been established, such as treadmill and voluntary wheel running and swim training models that all associate with cardiac growth. These approaches have been applied to numerous animal models with various backgrounds. However, important differences exist between these experimental approaches, which may affect the interpretation of the results. Here, we review the various approaches that have been used to experimentally study exercise training-induced cardiac hypertrophy; including the advantages and disadvantages of the various models.
