Document Detail

Disappearance of left ventricular hypertrabeculation/noncompaction after biventricular pacing in a patient with polyneuropathy.
MedLine Citation:
PMID:  17448419     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Disappearance of left ventricular hypertrabeculation/noncompaction (LVHT) has been reported only in myocarditis. We report disappearance of LVHT after implantation of a biventricular pacemaker in a 68-year-old female. She suffered from symmetrical polyneuropathy and heart failure New York Heart Association Class IV due to dilated cardiomyopathy despite angiotensin-converting enzyme inhibitors, beta-blockers, digitalis, and diuretics. Echocardiographically, she showed an enlarged poorly contracting left ventricle with LVHT involving the lateral and apical wall. METHODS AND RESULTS: In January 2001, a biventricular pacemaker system was implanted. From that time, her condition and left ventricular systolic function improved and the left ventricular size decreased. Surprisingly, LVHT could no longer be detected echocardiographically. CONCLUSIONS: We explain LVHT disappearance as follows: (1) the trabeculations are still existing, but not visible any more because of the better contraction state of the left ventricle; (2) the trabeculations have regressed because they are not needed anymore; and (3) the trabeculations have been falsely diagnosed and were in fact ventricular thrombi, which is quite unlikely because no embolic events occurred. LVHT can disappear if dilatation of the cardiac cavities and severely reduced systolic function regress. The dynamics of LVHT may represent an adaption mechanism of the cardiac function to compensate for a temporary failing myocardium.
Claudia Stöllberger; Hans Keller; Josef Finsterer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  13     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-23     Completed Date:  2007-06-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  211-4     Citation Subset:  IM    
Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria.
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MeSH Terms
Bundle-Branch Block / complications,  diagnosis,  therapy
Cardiac Pacing, Artificial / methods*
Cardiotonic Agents / therapeutic use
Follow-Up Studies
Heart Failure / complications,  diagnosis,  therapy
Hypertrophy, Left Ventricular / complications*,  therapy*,  ultrasonography
Pacemaker, Artificial
Polyneuropathies / complications*
Treatment Outcome
Reg. No./Substance:
0/Cardiotonic Agents

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