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At least 19 recordsLinked to original sources
PubMedDate not supplied

Heart size in inbred strains of rats. Part 2. Cardiovascular DNA and RNA contents during the development of cardiac enlargement in rats.

Enlargement and nucleic acid content of the cardiovascular system of several strains (SHRSP/N, SHR/N, OM/N, M520/N) of rats were compared with the WKY/N strain in an attempt to characterize cardiac enlargement. Cardiac enlargement in rats can be due to either hypertrophy (increase in myocyte size), hyperplasia (increase in cell number including supporting tissue), or a combination of both. The sum of the indices of the degree of hypertrophy and hyperplasia calculated from the difference of the heart and aorta deoxyribonucleic acid (DNA) concentration and total DNA content between each strain and the WKY/N was almost equal to the degree of heart and aorta enlargement. The SHRSP/N revealed a striking hypertrophy of myocardial cells from the prehypertensive stage, and hyperplasia appeared gradually with the elevation of blood pressure. In contrast, the SHR/N developed a marked hyperplasia with some hypertrophy at the prehypertensive stage. Cardiac enlargement of the OM/N was attributed to both hypertrophy and hyperplasia. A large heart weight of the M520/N was recognized at only a young age, and was due almost entirely to hyperplasia. Aortic enlargements were related to hyperplasia. An increased ribonucleic acid (RNA) concentration was observed in both ventricles of the SHRSP/N, SHR/N, and M520/N rats at 4 weeks of age, and in all of the four strains at 16 weeks of age. A significantly higher RNA concentration was indicated in the aorta of three hypertensive strains of SHRSP/N, SHR/N, and OM/N at established hypertensive stage. These changes might be related to manifestations of genetic or other factors such as the effect of elevated blood pressure.

Animals↗
PubMed1988

The effects of reserpine upon the cardiac enlargement of copper deficiency.

Copper (Cu) deficiency, induced in rats by suckling from Cu-deficient dams and by offering a semisynthetic low-Cu diet from weaning, resulted in cardiac enlargement. This enlargement was not due to accumulation of excess fluid in the heart but was characterized by mitochondrial hypertrophy as demonstrated by electron microscopy and biochemical studies. Administration of reserpine limited the extent of cardiac enlargement; however, heart total noradrenaline (NA), unchanged by Cu deficiency, was significantly reduced by reserpine. It was concluded that cardiac enlargement in Cu deficiency was not directly related to NA concentration. An alteration in cardiac energy status, however, was suggested by reduction in activity of the nonheme iron-dependent enzyme, succinic dehydrogenase.

Age Factors↗
PubMed2003

Insulin regulation in AhR-null mice: embryonic cardiac enlargement, neonatal macrosomia, and altered insulin regulation and response in pregnant and aging AhR-null females.

The aryl hydrocarbon receptor (AhR) was originally characterized because of its high affinity binding of 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin. However, studies using AhR-null mice have demonstrated the importance of this protein in normal physiology and development. Here we demonstrate that AhR-null embryos develop cardiac enlargement, and that this phenotype is dependent, at least in part, on the maternal genotype. Neonates born to AhR-null females had increased heart weights regardless of the neonatal genotype, an outcome also observed in gestational diabetes. The cardiac hypertrophy markers, beta-myosin heavy chain and atrial natriuretic factor, and the cardiac proliferative index were increased in AhR-null embryos, indicating that the cardiac enlargement is associated with myocyte hypertrophy and hyperplasia, which begin prior to birth. Importantly, two- to three-month-old pregnant and seven-month-old nonpregnant females, but not nonpregnant three-month-old AhR-null females had significantly decreased fasting plasma insulin levels and a reduced ability to respond to exogenous insulin compared to controls. Despite these alterations in insulin regulation and responsiveness, pregnant AhR females did not have abnormal glucose tolerance tests and did not develop hyperglycemia, classic characteristics of gestational diabetes. However, twenty-three percent of seven-month-old AhR-null females did have altered glucose tolerance tests, but did not show hyperglycemia or increased hemoglobin A1C concentration under normal feeding conditions. While the ultimate cause of the neonatal phenotype remains unclear, these studies establish that the AhR is required for normal insulin regulation in pregnant and older mice and for cardiac development in embryonic mice.

Age Factors↗
PubMedDate not supplied

Heart size on chest x-ray as a predictor of cardiac enlargement by echocardiography in children.

To determine the usefulness of heart size on chest radiograph (CXR) in predicting cardiac enlargement (CE) in children, we prospectively evaluated 95 consecutive outpatients, who had both a CXR and echocardiography performed. Their median age was 5.0 years (2 days to 19.9 years). All patients underwent CXR assessment by a pediatric radiologist, with classification of cardiac silhouette as normal, borderline, or enlarged. Echocardiographic assessment of CE was performed by a pediatric echocardiographer. Sensitivity, specificity, and predictive values of the pediatric radiologist's interpretation of heart size on CXR were estimated. The presence of CE by echocardiography was used as the gold standard. Seventy-nine patients (83.2%) had no CE on CXR, and 16 patients (16.8%) had CE. Sensitivity of the CXR to identify CE was 58.8%, 95% confidence interval (CI) [32.9, 81.6], with a positive predictive value of 62.5% [35.4, 84.8]. Specificity was 92.3% [84.0, 97.1], with a negative predictive value of 91.1% [82.6, 96.4]. These data suggest that the assessment of CE on CXR to predict CE by echocardiography has a relatively high specificity and negative predictive value, but a low sensitivity and positive predictive value. The limitations of CXR as a diagnostic test should be understood by clinicians using the test when screening children for cardiac disease.

Adolescent↗
PubMedDate not supplied

Mechanism of pericardial expansion with cardiac enlargement.

BACKGROUND: The normal pericardial sac accommodates a 250-350 gram heart and 15-50 ml of pericardial fluid. Cardiac enlargement and/or increases in fluid must be accompanied by an increase in pericardial volume and a concomitant expansion of the pericardial sac. The mechanism of such expansion has been debated, but theoretical considerations include fibroblastic proliferation with new connective tissue deposition versus remodeling of the pre-existent connective tissue. DESIGN: Nineteen pericardia were obtained from consecutive adult autopsies. Total pericardial fluid was measured; the absolute value of pericardial fluid volume and cardiac weight were added to create a total score. Representative pericardial tissue was stained with hematoxylin-eosin (H&E), Masson's trichrome, and Verhoeff's elastin stain (EVG). An additional archival case with the pericardium from a 900-g heart with 1,000-ml of fluid was also included. RESULTS: None of the sections showed histologic evidence of fibroblastic proliferation. Parameters indicative of collagen stretching or damage were evaluated. The greatest correlative factor in identifying an enlarged pericardium was the average of four measurements of the greatest distance between elastic fibers surrounding obliquely oriented collagen layers. Five of six cases with a cardiac score > 450 showed an average measurement of less than 15 microns, and 10 of 14 cases with a cardiac score < or = 450 showed an average measurement of > 15 microns = 0.0498). Histologic and ultrastructural evidence of collagen damage was identified in the pericardium from the 900-g heart with the 1,000-ml effusion. CONCLUSIONS: We propose that collagen stretching and slippage of obliquely oriented collagen layers contribute to the increased surface area needed to accommodate larger volumes. When these limits are exceeded, collagen damage ensues.

Adult↗
PubMed1975

Giant intrathoracic tumor masquerading as an enlarged cardiac silhouette.

This report describes a relatively asymptomatic 52-year-old man who had a markedly enlarged cardiac silhouette on chest roentgenogram when first seen. Clinical studies confirmed the presence of a mass, and thoracotomy revealed a huge intrathoracic tumor. The lesion was interpreted as an intrapulmonary hamartoma that had undergone malignant degeneration.

Cardiomegaly↗
PubMed1985

Symmetric cardiac enlargement in highly trained endurance athletes: a two-dimensional echocardiographic study.

Twelve highly trained male endurance athletes and 12 normally active matched control subjects were studied by two-dimensional and M-mode echocardiography to evaluate changes in the right and left heart chambers associated with intense aerobic training. Maximal oxygen uptake, a measure of cardiovascular fitness, ranged from 62.1 to 82.6 ml/kg/min in the athletes and from 33.0 to 49.3 ml/kg/min in the control subjects (p less than 0.001). The athletes had significantly greater left ventricular wall thickness (p less than 0.01), left ventricular chamber area (p less than 0.005), left atrial area (p less than 0.01), right ventricular chamber area (p less than 0.002), right ventricular wall thickness (p less than 0.05), and right atrial area (p less than 0.01). Proportionality of cardiac chamber enlargement in the athletes was shown by similar ratios of both right-to-left ventricular areas and right-to-left atrial areas in the two groups. Left ventricular contractility was not significantly different between groups. Cardiac enlargement in endurance athletes enables a greater stroke volume for the performance of sustained, intense exercise; hypertrophy of the chamber walls normalizes wall stress. These changes occur symmetrically in both right and left cardiac chambers in the endurance athlete, reflecting bilateral hemodynamic loading. The symmetry of the endurance athlete's cardiac enlargement differs from most pathologic conditions which have heterogeneous effects on specific cardiac chambers.

Adult↗
PubMed1979

[Diagnosis and differential diagnosis of cardiac enlargement in the chest film. Systematic survey (author's transl)].

The pathological enlarged heart is attempted to define by roentgenologic criteria. The historical "heart lung quotient" continues to be an important measurement. Alterations of the heart size secondary to age, the systolic-diastolic difference of the heart size and the alterations of the heart size between two chest films are discussed. Differential diagnosis of enlargement and shape of the left and right heart are presented. Also the differential diagnosis of general cardiac enlargement especially valvular heart disease, combined left and right heart failure, pericardial effusion and myocardiopathy is considered.

Aortic Valve Insufficiency↗
PubMed1982

Effects of the adrenergic nervous system on training-induced cardiac enlargement, and on the intrinsic rate and phenylephrine sensitivity of isolated rat atria.

Atria isolated from rats after 6 to 7 weeks running training or swim training in water at 30 degrees C beat at a slower rate than did the atria from sedentary control animals. If the rats received noradrenaline injections with each running session their atrial rate was even lower, while propranolol injections did not lead to lower intrinsic atrial rate. Repeated noradrenaline or propranolol injections alone or swim training in warm water (38 degrees C) did not result in altered atrial rate. A plot of the intrinsic atrial rate against heart weight yielded a significant (r = -0.803) negative relationship (y = 311 - 0.91 x). Swim training in cold water, or chronic noradrenaline injections led to a lessened sensitivity of isolated atria to phenylephrine while chronic beta blockade tended to increase the sensitivity. The results suggest that an intense, although transient, cardiac stimulation, typical of the combined action of running training and noradrenaline injections, results in a lower intrinsic atrial rate and greater cardiac enlargement, while a more sustained type of cardiac stimulation, as produced typically by repeated injections of noradrenaline, leads to less sensitivity to phenylephrine.

Adaptation, Physiological↗
PubMed2004

Mice with cardiac-restricted angiotensin-converting enzyme (ACE) have atrial enlargement, cardiac arrhythmia, and sudden death.

To investigate the local effects of angiotensin II on the heart, we created a mouse model with 100-fold normal cardiac angiotensin-converting enzyme (ACE), but no ACE expression in kidney or vascular endothelium. This was achieved by placing the endogenous ACE gene under the control of the alpha-myosin heavy chain promoter using targeted homologous recombination. These mice, called ACE 8/8, have cardiac angiotensin II levels that are 4.3-fold those of wild-type mice. Despite near normal blood pressure and a normal renal function, ACE 8/8 mice have a high incidence of sudden death. Both histological analysis and in vivo catheterization of the heart showed normal ventricular size and function. In contrast, both the left and right atria were three times normal size. ECG analysis showed atrial fibrillation and cardiac block. In conclusion, increased local production of angiotensin II in the heart is not sufficient to induce ventricular hypertrophy or fibrosis. Instead, it leads to atrial morphological changes, cardiac arrhythmia, and sudden death.

Angiotensin II↗
PubMed1986

Renal involvement follows cardiac enlargement in essential hypertension.

To assess the relationship between early clinically detectable involvement of hypertensive vascular disease in heart and kidneys, we obtained systemic and renal hemodynamic and M-mode echocardiographic measurements in 65 patients with essential hypertension. The results indicate that patients with and without left ventricular hypertrophy had similar renal hemodynamic findings. In contrast, patients with altered renal hemodynamic measurements (ie, reduced renal distribution of cardiac output and, therefore, absolute renal blood flow with increased renal vascular resistance) and increased serum uric acid levels also had increased left ventricular posterior and septal wall thicknesses and mass index. Moreover, these data also demonstrated that in patients with altered renal hemodynamics, the lower the renal distribution of cardiac output and the higher the serum uric acid levels, the greater were the indexes of cardiac enlargement. These results demonstrated that the pathophysiological and hemodynamic effects of essential hypertension in the heart precede those in the kidneys.

Adult↗
PubMed1995

Overexpression of NGF within the heart of transgenic mice causes hyperinnervation, cardiac enlargement, and hyperplasia of ectopic cells.

Nerve growth factor (NGF) supports the survival of developing sympathetic and a subpopulation of sensory neurons. In the adult it participates in maintenance of the neurotransmitter phenotype of responsive neurons. The amount of NGF synthesized by a given target tissue determines its final innervation density; those developing neurons that fail to receive sufficient NGF undergo apoptosis. In order to examine the ramifications of this principle in the context of a specific target organ, a transgenic mouse model was developed in which NGF expression was increased in developing and adult cardiac tissue by placing a NGF minigene under the transcriptional control of the cardiac-specific alpha-myosin heavy chain promoter. Transgenic mice developed cardiac enlargement secondary to both an increase in myocardial mass and the presence of an abundant ectopic cell population. Immunohistochemical analyses with the neural marker S-100 revealed staining of a subpopulation of ectopic cells, suggesting their derivation from the neural crest. Whereas immunostaining for the neuronal-specific protein neuron-specific enolase demonstrated labeling of another subpopulation of ectopic cells within the heart. Measurements of cardiac tissue catecholamine levels revealed a marked elevation in transgenic mice, consistent with sympathetic hyperinnervation. Analysis of mediastinal sympathetic ganglia revealed increases in both the size and the number of neurons. In this model, increased expression of NGF produced hyperinnervation of the heart, pathological cardiac growth, and the recruitment and/or expansion of an ectopic, neural crest-derived cell type.

Animals↗