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Question:
What does concentric LV remodeling with LVMI of 70gm/m2 and relative wall thickness and contractility mean?
submitted by Pam from Florida on 11/14/2015
Answer:
by Texas Heart Institute cardiovascular surgeon, William E. Cohn, MD
Hey Pam.
The terms you have asked about are used to describe the size and shape of the left ventricle, the main pumping chamber of the heart. When the heart is exposed to higher than normal pressure over long periods of time as is seen with high blood pressure or aortic valve narrowing, the heart muscle cells that make up the left ventricle begin to swell. As a result, the walls of the ventricle become progressively thickened and the heart becomes more massive. Since the chamber of the left ventricle (the part that fills with blood) doesn't generally enlarge in this setting, we talk about the mass of the heart, not the size... i.e... we don't say the heart is "enlarged", we say it is "hypertrophied", a medical term that refers to the thickened walls. Remodeling refers to the gradual change over time of the wall thickness, and concentric means it involves all the aspects of the left ventricle... the increased thickness isn't focused in one specific area of the heart wall.
It is somewhat similar to the way one's bicep muscle enlarges after prolonged heavy weight lifting. In the heart, however, these changes can be deleterious. As the heart wall thickens, the ability of the heart to relax in between heart beats gradually worsens, which can lead to a form of heart failure. If identified early, hypertrophy can be halted and even reversed if the underlying abnormality is aggressively treated.
LVMI or left ventricular mass index, is a calculated number that lets us determine how advanced the hypertrophy is, regardless of the size of the patient. A 7 foot tall 300 pound male patient should have a heart that is significantly heavier than the heart of a 4 foot 6 inch 90 pound female. By dividing the mass of the heart by the surface area of the patient, it allows one to make a critical appraisal of the heart mass for a patient of any given size.
I think the last sentence "and relative wall thickness and contractility" is missing a word... perhaps "relatively normal" or "relatively preserved"... it doesn't mean anything without the missing word. If the missing word was either normal or preserved, it simply means that the heart still beats well.
I hope this is helpful.
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Updated December 2015
