Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies

Aims To phenotype patients referred to a tertiary centre for the exploration of a left ventricular hypertrophy (LVH) starting from 12 mm of left ventricular wall thickness (LVWT).Methods and results Consecutive patients referred for aetiological workup of LVH, beginning at 12 mm of LVWT were retrosp...

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Main Authors: Didier Carrié, Stéphanie Brun, Eve Cariou, Michel Galinier, Maxime Beneyto, Jérémy Brunel, Alex Scripcariu, Hubert Delasnerie, Delphine Dupin Deguine
Format: Article
Language:English
Published: BMJ Publishing Group 2021-02-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/8/1/e001462.full
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author Didier Carrié
Stéphanie Brun
Eve Cariou
Michel Galinier
Maxime Beneyto
Jérémy Brunel
Alex Scripcariu
Hubert Delasnerie
Delphine Dupin Deguine
author_facet Didier Carrié
Stéphanie Brun
Eve Cariou
Michel Galinier
Maxime Beneyto
Jérémy Brunel
Alex Scripcariu
Hubert Delasnerie
Delphine Dupin Deguine
author_sort Didier Carrié
collection DOAJ
description Aims To phenotype patients referred to a tertiary centre for the exploration of a left ventricular hypertrophy (LVH) starting from 12 mm of left ventricular wall thickness (LVWT).Methods and results Consecutive patients referred for aetiological workup of LVH, beginning at 12 mm of LVWT were retrospectively included in this tertiary single-centred observational study. Patients presenting with severe aortic stenosis were excluded. Aetiological workup was reviewed for each subject and aetiologies were adjudicated by expert consensus.Among 591 patients referred for LVH aetiological workup, 41% had a maximal LVWT below 15 mm. LVH aetiologies were led by cardiac amyloidosis (CA, 34.3%), followed by sarcomeric hypertrophic cardiomyopathy (S-HCM, 32.1%), hypertensive cardiomyopathy (21.7%), unknown aetiology (7.6%) and other (4.2%), including Anderson-Fabry’s disease (1.7%). CA and S-HCM affected over 50% of patients with mild LVH (12–14 mm); the prevalence of these aetiologies rose with LVH severity. Among patients with Anderson-Fabry’s disease, 4 (40%) had a maximal LVWT <15 mm.Conclusions Mild LVH (ie, 12–14 mm) conceals multiple aetiologies that can lead to specific treatment, cascade family screening and specific follow-up. Overall, CA is nowadays the leading cause of LVH in tertiary centers.
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issn 2053-3624
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spelling doaj-art-5df97180b3f34686857eb5dbc7c8313a2024-11-11T19:15:08ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2020-001462Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologiesDidier Carrié0Stéphanie Brun1Eve Cariou2Michel Galinier3Maxime Beneyto4Jérémy Brunel5Alex Scripcariu6Hubert Delasnerie7Delphine Dupin Deguine8Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France1 Cardiology, University Hospital of Rangueil, Toulouse, FranceCardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, FranceCardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, FranceCardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, FranceCardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, FranceCardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, FranceCardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, FranceGenetics, CHU Toulouse, Toulouse, FranceAims To phenotype patients referred to a tertiary centre for the exploration of a left ventricular hypertrophy (LVH) starting from 12 mm of left ventricular wall thickness (LVWT).Methods and results Consecutive patients referred for aetiological workup of LVH, beginning at 12 mm of LVWT were retrospectively included in this tertiary single-centred observational study. Patients presenting with severe aortic stenosis were excluded. Aetiological workup was reviewed for each subject and aetiologies were adjudicated by expert consensus.Among 591 patients referred for LVH aetiological workup, 41% had a maximal LVWT below 15 mm. LVH aetiologies were led by cardiac amyloidosis (CA, 34.3%), followed by sarcomeric hypertrophic cardiomyopathy (S-HCM, 32.1%), hypertensive cardiomyopathy (21.7%), unknown aetiology (7.6%) and other (4.2%), including Anderson-Fabry’s disease (1.7%). CA and S-HCM affected over 50% of patients with mild LVH (12–14 mm); the prevalence of these aetiologies rose with LVH severity. Among patients with Anderson-Fabry’s disease, 4 (40%) had a maximal LVWT <15 mm.Conclusions Mild LVH (ie, 12–14 mm) conceals multiple aetiologies that can lead to specific treatment, cascade family screening and specific follow-up. Overall, CA is nowadays the leading cause of LVH in tertiary centers.https://openheart.bmj.com/content/8/1/e001462.full
spellingShingle Didier Carrié
Stéphanie Brun
Eve Cariou
Michel Galinier
Maxime Beneyto
Jérémy Brunel
Alex Scripcariu
Hubert Delasnerie
Delphine Dupin Deguine
Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
Open Heart
title Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
title_full Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
title_fullStr Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
title_full_unstemmed Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
title_short Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
title_sort tip of the iceberg a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies
url https://openheart.bmj.com/content/8/1/e001462.full
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