Affiliation:
1. Department of Cardiology University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital Istanbul Turkey
2. Department of Cardiology & Biostatistics Istanbul Nisantasi University Medical School Istanbul Turkey
3. Bahcesehir University Faculty of Medicine Istanbul Turkey
4. Department of Cardiology University of Health Sciences, Basaksehir Cam Sakura City Hospital Istanbul Turkey
5. Department of Hematology University of Health Sciences, Van Training and Research Hospital Van Turkey
6. Department of Nuclear Medicine University of Health Sciences, Basaksehir Cam Sakura City Hospital Istanbul Turkey
7. Department of Radiology University of Health Sciences, Mehmet Akif Ersoy Thoracic Cardiovascular Surgery Training and Research Hospital Istanbul Turkey
Abstract
AbstractBackgroundLeft ventricular hypertrophy (LVH), including hypertensive LVH, hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis (CA), is a commonly encountered condition in cardiology practice, presenting challenges in differential diagnosis. In this study, we aimed to investigate the importance of echocardiographic evaluation of the inferior vena cava (IVC) in distinguishing LVH subtypes including hypertensive LVH, HCM, and CA.MethodsIn this retrospective study, patients with common causes of LVH including hypertensive LVH, HCM, and CA were included. The role of echocardiographic evaluation of IVC diameter and collapsibility in distinguishing these causes of LVH was assessed in conjunction with other echocardiographic, clinical, and imaging methods.ResultsA total of 211 patients (45% HCM, 43% hypertensive heart disease, and 12% CA) were included in our study. Their mean age was 56.6 years and 62% of them were male. While mean IVC diameter was significantly dilated in CA patients (13.4 mm in hypertensive LVH, 16.0 mm in HCM, and 21.1 mm in CA, p < .001), its collapsibility was reduced (IVC collapsible in 95% of hypertensive patients, 72% of HCM patients, and 12% of CA patients, p < .001). In the analysis of diagnostic probabilities, the presence of both hypovoltage and IVC dilation is significant for CA patients. Although it is not statistically significant, the presence of IVC dilation along with atrial fibrillation supports the diagnosis of HCM.ConclusionIn conclusion, although advances in imaging techniques facilitate the diagnosis of LVH, simple echocardiographic methods should never be overlooked. Our study supports the notion that IVC assessment could play an important role in the differential diagnosis of LVH.