Abstract：
BACKGROUND: Left 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.
METHODS: In 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.
RESULTS: A 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.
CONCLUSIONS: In 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.
METHODS: In 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.
RESULTS: A 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.
CONCLUSIONS: In 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.
摘要：
背景：左心室肥厚（LVH），包括高血压LVH，肥厚型心肌病（HCM）和心脏淀粉样变性（CA），是心脏病学实践中常见的一种情况，在鉴别诊断中提出了挑战。在这项研究中,我们旨在探讨下腔静脉（IVC）的超声心动图评估在区分包括高血压LVH在内的LVH亚型中的重要性，HCM,和CA。
方法：在这项回顾性研究中，患者的常见原因包括高血压LVH，HCM,包括CA。结合其他超声心动图评估IVC直径和塌陷性在区分这些LVH原因中的作用。临床,和成像方法。
结果：总共211名患者（45％的HCM，43%高血压性心脏病,和12%CA)被纳入我们的研究。他们的平均年龄为56.6岁，其中62％为男性。虽然CA患者的平均IVC直径显着扩张（高血压LVH患者为13.4mm，HCM中16.0mm,和21.1毫米的CA，p<.001),其塌陷性降低(95%的高血压患者IVC塌陷，72%的HCM患者，12%的CA患者，p<.001)。在诊断概率的分析中，对于CA患者,低电压和IVC扩张的存在是显著的.虽然没有统计学意义，IVC扩张和心房颤动的存在支持HCM的诊断.
结论：结论：尽管成像技术的进步有助于LVH的诊断，简单的超声心动图检查方法不容忽视.我们的研究支持IVC评估可能在LVH的鉴别诊断中起重要作用的观点。
方法：在这项回顾性研究中，患者的常见原因包括高血压LVH，HCM,包括CA。结合其他超声心动图评估IVC直径和塌陷性在区分这些LVH原因中的作用。临床,和成像方法。
结果：总共211名患者（45％的HCM，43%高血压性心脏病,和12%CA)被纳入我们的研究。他们的平均年龄为56.6岁，其中62％为男性。虽然CA患者的平均IVC直径显着扩张（高血压LVH患者为13.4mm，HCM中16.0mm,和21.1毫米的CA，p<.001),其塌陷性降低(95%的高血压患者IVC塌陷，72%的HCM患者，12%的CA患者，p<.001)。在诊断概率的分析中，对于CA患者,低电压和IVC扩张的存在是显著的.虽然没有统计学意义，IVC扩张和心房颤动的存在支持HCM的诊断.
结论：结论：尽管成像技术的进步有助于LVH的诊断，简单的超声心动图检查方法不容忽视.我们的研究支持IVC评估可能在LVH的鉴别诊断中起重要作用的观点。
