Diagnostik der linksventrikulären Hypertrophie

  • R. B. Devereux
  • R. E. Schmieder
Conference paper

Zusammenfassung

Die Bestimmung der Herzanatomie und kardialen Strukturen bei Patienten mit arterieller Hypertonie stellt einen wichtigen Bestandteil in der Evaluierung dieser Patientengruppe dar. Erste prognostische Aussagen über die Beziehung von arterieller Hypertonie, Herzhypertrophie und Herzinsuffizienz lieferte die Framingham-Studie [28, 29]. Über 75% aller Patienten, die im Verlauf der Studie eine Herzinsuffizienz entwickelten, wiesen als Grunderkrankung eine arterielle Hypertonie auf. Sie verursachte entweder direkt infolge der chronischen Nachlasterhöhung oder indirekt als Risikofaktor der koronaren Herzkrankheit ein myokardiales Pumpversagen. Bei Hypertonikern mit elektrokardiographisch nachweisbaren Zeichen einer Linksherzhypertrophie lag das Risiko, im Verlauf ihrer Erkrankung eine Herzinsuffizienz zu entwickeln, um ein Zehnfaches höher als bei Patienten ohne Hypertrophiezeichen im EKG [29]. Ergebnissen des Hypertension Detection and Follow-up Programs zufolge war die Fünfjahresmortalitätsrate bei den 40–69 jährigen männlichen Hypertonikern 2–3mal so hoch, wenn gleichzeitig im EKG Zeichen der Linksherzhypertrophie vorlagen, wie wenn keine Hypertrophiezeichen im EKG nachweisbar waren [46].

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Literatur

  1. 1.
    Bahler AS, Teichholz LE, Gorlin R, Herman MV (1977) Correlations of electrocardiography and echocardiography in determination of left ventricular wall thickness. Study of apparently normal subjects. Am J Cardiol 39: 184–195CrossRefGoogle Scholar
  2. 2.
    Breslin DJ, Gifford RW Jr, Fairbain JF II (1966) Essential hypertension: a twenty-year follow-up study. Circulation 33: 87–97PubMedGoogle Scholar
  3. 3.
    Casale PN, Devereux RB, Milner M, Zullo G, Harshfield GA, Pickering TG, Laragh JH (1986) Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. Ann Intern Med 105: 173–178PubMedGoogle Scholar
  4. 4.
    Chikos PM, Figley MM, Fischer L (1977) Correlation between ehest film and angiographic assessment of left ventricular size. AJR 128: 367–373PubMedGoogle Scholar
  5. 5.
    Clark RD, Viosenska K, Cohn K (1980) Serial echocardiographic evaluation of left ventricular funetion in valvulär disease including reproducibility guidelines for serial studies. Circulation 62: 564–575PubMedGoogle Scholar
  6. 6.
    Conn RD, Cole JS (1971) The cardiac apex impulse: clinical and angiographic correlations. Ann Intern Med 75: 185–191PubMedGoogle Scholar
  7. 7.
    Crawford MH, Grant D, O’Rourke RA, Starling MR, Groves BM (1980) Accuracy and reproducibility of new M-mode echocardiographic recommendations for measuring left ventricular dimensions. Circulation 61: 137–143PubMedGoogle Scholar
  8. 8.
    Devereux RB (1987) Detection of left ventricular hypertrophy in M-mode echocardiography: Anatomie Validation, standardization, and comparison to other methods. Hypertension [Suppl II] 9: 19–26Google Scholar
  9. 9.
    Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiograhic assessment of left ventricular hypertrophy: Comparison to necropsy findings. Am J Cardiol 57: 450–458PubMedCrossRefGoogle Scholar
  10. 10.
    Devereux RB, Alonso DR, Lutas EM, Pickering TG, Harshfield GA, Laragh JH (1983) Sensitivity of echocardiography for detection of left ventricular hypertrophy. In: ter Keurs HEDJ, Schipperheyn JJ (eds) Cardiac left ventricular hypertrophy. Martinus-Nijhoff, The Hague, pp 16–37CrossRefGoogle Scholar
  11. 11.
    Devereux RB, Casale PN, Eisenberg RR, Miller DH, Kligfield P (1984) Electocardiographic detection of left ventricular hypertrophy using echocardiographic determination of left ventricular mass as the reference Standard: comparison of Standard criteria, Computer diagnosis and physician interpretation. J Am Coli Cardiol 3: 82–87CrossRefGoogle Scholar
  12. 12.
    Devereux RB, Lutas EM, Casale PN et al. (1984) Standardization of M-mode echocardiographic left ventricular anatomic measurements. JACC 4: 1222–1230PubMedGoogle Scholar
  13. 13.
    Devereux RB, Reichek N (1977) Echocardiographic determination of left ventricular mass in man: Anatomic Validation of the method. Circulation 55: 613–618PubMedGoogle Scholar
  14. 14.
    Devereux RB, Savage DD, Sachs I, Laragh JH (1983) Relation of hemodynamic load to left ventricular hypertrophy and Performance in hypertension. Am J Cardiol 51: 171–176PubMedCrossRefGoogle Scholar
  15. 15.
    Drayer JIM, Savage DD, Henry WL, Mathews EC, Laragh JH, Epstein SH (1976) Incidence of echocardiographic left ventricular hypertrophy and left atrial enlargement in essential hypertension (abstract). Circulation [Suppl I] 53 /54: 233Google Scholar
  16. 16.
    Dreslinski GR (1983) Identification of left ventricular hypertrophy: ehest roentgenography, echocardiography and electrocardiography. Am J Med [Suppl 3 A] 75: 47–50Google Scholar
  17. 17.
    Dumesnil JG, Laurencean JL (1977) Echocardiographic analysis of left ventricular wall thickness. Cardiovasc Med 2: 1005–1010Google Scholar
  18. 18.
    Gaasch WH (1979) Left ventricular radius to wall thickness ratio. Am J Cardiol 43: 1189–1194PubMedCrossRefGoogle Scholar
  19. 19.
    Gardin JM, Henry WL, Savage DD, Ware JH, Burn C, Borer JS (1974) Echocardiographic measurements in normal subjects: evaluation of an adult population without clinically apparent heart disease. JCV 7: 439–447Google Scholar
  20. 20.
    Gertsch M, Theler A, Foglia E (1988) Electrocardiographic detection of left ventricular hypertrophy in the presence of left anterior fascicular block. Am J Cardiol 61: 1098–1101PubMedCrossRefGoogle Scholar
  21. 21.
    Glover L, Baxley WA, Dodge HT (1973) A quantitative evaluation of heart size measurements from ehest roentgenograms. Circulation 47: 1289–1296PubMedGoogle Scholar
  22. 22.
    Grant RP (1957) The spatial vector approach: Clinical electrocardiography. McGraw-Hill, New YorkGoogle Scholar
  23. 22a.
    Helgeland A (1980) Treatment of mild hypertension in a five-year controlled drug trial — the Oslo study. Am J Med 69: 725–730PubMedCrossRefGoogle Scholar
  24. 23.
    Henry WL, Clark CE, Epstein SE (1973) Asymmetrie septal hypertrophy: echocardiographic identification of the pathognomonic anatomic abnormality of IHSS. Circulation 47: 225–233PubMedGoogle Scholar
  25. 24.
    Henry WL, Clark CE, Epstein SE (1973) Asymmetrie septal hypertrophy (ASH): the unifying link in the IHSS disease spectrum: observations regarding its pathogenesis, pathophysiology and course. Circulation 47: 827–832PubMedGoogle Scholar
  26. 25.
    Henry WL, Gardin JM, Ware JH (1980) Echocardiographic measurements in normal subjects from infancy to old age. Circulation 62: 1054–1061PubMedGoogle Scholar
  27. 26.
    Henry WL, Ware J, Gardin JM, Hepner SI, McKay J, Weiner M (1978), Echocardiographic measurements in normal subjects. Circulation 57: 278–285PubMedGoogle Scholar
  28. 27.
    Holt JH Jr, Barnard ACL, Lynn MS (1969) A study of the human heart as a multiple dipole electrical source: II. Diagnosis and quantitation of left ventricular hypertrophy. Circulation 40: 697–710PubMedGoogle Scholar
  29. 27a.
    HDFP-Cooperative Study Group (1982) Hypertension Detection and Follow–up Program Cooperative Study Group: The effect of treatment on mortality in „mild” hypertension: results of the HDFP. N Engl J Med 307: 976–980CrossRefGoogle Scholar
  30. 28.
    Kannel WB, Castelli WP, McNamara PM, McKee PA, Feinleib M (1972) Role of blood pressure in the development of congestive heart failure: The Framingham Study. N Engl J Med 287: 781–787PubMedCrossRefGoogle Scholar
  31. 28a.
    Kannel WB, Gordon T, Castelli WP, Margolis JR (1970) Electrocardiographic left ventricular hypertrophy and risk of coronary heart disease. Ann Intern Med 72: 813–819PubMedGoogle Scholar
  32. 29.
    Kannel WB, Dawber TR (1973) Hypertensive cardiovascular disease. The Framingham Study. In: Onesti G, Kim KE, Maya ED (eds) Hypertension: Mechanisms and management. Grüne & Stratton, New York, pp 93–118Google Scholar
  33. 30.
    Karliner JS, Williams D, Gorwit J, Crawford MH, O’Rourke RA (1977) Left ventricular Performance in patients with left ventricular hypertrophy caused by systemic arterial hypertension. Br Heart J 39: 1239–1245CrossRefGoogle Scholar
  34. 31.
    Keats TE, Enge IP (1965) Cardiac measuration by the cardiac volume method. Radiology 85: 850–855PubMedGoogle Scholar
  35. 32.
    Kennedy JW, Reichenbach DD, Baxley WA, Dodge HT (1967) Left ventricular mass: a comparison of angiocardiographic measurements with autopsy weight. Am J Cardiol 19: 221–224PubMedCrossRefGoogle Scholar
  36. 32a.
    Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH (1991) Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114: 345–352PubMedGoogle Scholar
  37. 33.
    Levy D, Savage DD, Garrison RJ, Anderson KM, Kannel WB, Castelli WP (1987) Echocardiographic criteria for left ventricular hypertrophy: The Framingham Heart Study. Am J Cadiol 59: 956–960CrossRefGoogle Scholar
  38. 34.
    Morgenroth J, Maron BJ, Henry WL, Epstein SE (1975) Comparative left ventricular dimensions in trained athletes. Ann Intern Med 82: 521–524Google Scholar
  39. 35.
    Morris JJ Jr, Estes EH, Whales RE, Thompson HK, Mclntosh HD (1964) P-wave analysis in valvulär heart disease. Circulation 29: 242PubMedGoogle Scholar
  40. 36.
    Reichek N, Devereux RB (1981) Left ventricular hypertrophy: Relationship of anatomic, echocardiographic and electrocardiographic findings. Circulation 63: 1391–1398PubMedCrossRefGoogle Scholar
  41. 37.
    Romhilt DW, Bove KE, Norris RJ et al. (1969) A critical appraisal of electrocardiographic criteria for the diagnosis of left ventricular hypertrophy. Circulaltion 40: 185–194Google Scholar
  42. 38.
    Romhilt DW, Estes EH Jr (1968) A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 75: 752–758PubMedCrossRefGoogle Scholar
  43. 39.
    Romhilt DW, Greenfield JC Jr, Estes EH Jr (1968) Vectorcardiographic diagnosis of left ventricular hypertrophy. Circulation 38: 15–19Google Scholar
  44. 40.
    Safar ME, Lehner JP, Vincent MI, Plainfosse MT, Simon AC (1979) Echocardiographic dimensions in borderline and sustained hypertension. Am J Cardiol 44: 930–935PubMedCrossRefGoogle Scholar
  45. 41.
    Sahn DJ, de Maria A, Kisslo J, Weyman A (1978) Recommendations regarding quantitation in M–mode echocardiography: results of a survey of echocardiographic measurements. Circulation 58: 1072–1080PubMedGoogle Scholar
  46. 42.
    Savage DD, Drayer JIM, Henry WL et al. (1979) Echocardiographic assessment of cardiac anatomy and function in hypertensive subjects. Circulation 59: 623–632PubMedGoogle Scholar
  47. 43.
    Schieken RM, Clarke WR, Mahoney CT, Lauer RM (1979) Measurement or criteria for group echocardiographic studies. Am J Epidermiol 110: 504–514Google Scholar
  48. 44.
    Sokolow M, Lyon TP (1949) The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J 37: 161–186PubMedCrossRefGoogle Scholar
  49. 45.
    Sokolow M, Perloff D (1961) The prognosis of essential hypertension treated conservatively. Circulation 23: 697–713Google Scholar
  50. 46.
    Tyroler HA (1983) Race, education, and 5 year mortality in HDFP Stratum I referred-care males. In: Gross F, Strasser T (eds) Mild hypertension: recent advances. Raven, New York, pp 163–175Google Scholar
  51. 47.
    Ungerleider HE (1947) Cardiac enlargement. Radiology 48: 129–147PubMedGoogle Scholar
  52. 48.
    Valdez RS, Motta JA, Condon E et al. (1979) Evaluation of the echocardiogram as an epidemiologic tool in an asymptomatic population. Circulation 60: 921–929PubMedGoogle Scholar
  53. 49.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents (1967) Effects of treatment on morbidity in hypertension I. Results in patients with diastolic blood pressures averaging 115 through 129 mmHg. JAMA 202: 1028–1034CrossRefGoogle Scholar
  54. 50.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents (1970) Effects of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressure averaging 90 through 114 mmHg. JAMA 213: 1143–1152CrossRefGoogle Scholar
  55. 51.
    Wallerson DC, Devereux RB (1987) Reproducibility of echocardiographic left ventricular measurements. Hypertension [Suppl II] 9: 11–6–11–18Google Scholar
  56. 52.
    Woythaler JN, Singer SL, Kwan OL et al. (1983) Accuracy of echocardiography versus electrocardiography in detecting left ventricular hypertrophy: Comparison with postmortem mass measurements. J Am Coli Cardiol 2: 305–311CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • R. B. Devereux
  • R. E. Schmieder

There are no affiliations available

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