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Background: Left ventricular mass (LVM) is an independent risk factor for cardiovascular outcome. We aimed to define normal reference values of LVM/body surface area (BSA) in a multiethnic Southeast Asian population across ages, and define demographic parameters that predict LVM/BSA., Methods: 198 subjects (44% men, mean age 40 +/- 14 years, 82% Chinese, 13% Malay and 5% Indian) with no cardiovascular comorbidity and had normal echo images for age were included in the analysis. Echo LVM was calculated as: 1.04 x[(left ventricular internal diameter at end-diastole [LVIDd]+ interventricular septal thickness at end-diastole [IVSd]+ left ventricular posterior wall thickness at end-diastole [LVPWd])(3)- LVIDd(3)x 0.8]+ 0.6(1), indexed by BSA (LVM/BSA)* and expressed as g/m(2)., Results: BSA and blood pressure (BP) were comparable between dichotomous age groups < or >or= 50 years within the same gender. Women aged >or= 50 years had larger IVSD, LVPWd, LVM and LVM/BSA compared to younger cohort. (p < 0.01 for all variables). The 95th percentile of LVM in men and women were 189 g and 148 g respectively; corresponding values for LVM/BSA were 106 and 96 g/m(2). These values are consistently smaller than published values from the West. Age (r = 0.27, P < 0.001), gender (r =-0.30, P < 0.001), and systolic BP (r = 0.25, P = 0.003) were significant univariate predictors of LVM/BSA., Conclusion: We therefore propose a different cutoff value for the diagnosis of LV hypertrophy among Southeast Asians.

Cor triatriatum dexter ( CTD) is an extremely rare congenital condition arising from the persistence of the right valve of the sinus venosus. It divides the right atrium (RA) into 2 separate chambers. We report a case of a 50-year-old man who had an incidental finding of CTD on transesophageal echocardiogram. An incomplete membrane of the RA was seen, and three-dimensional echocardiogram delineated the structure clearly as a triangular sail-like structure with multiple orifices and a fenestration. [ABSTRACT FROM AUTHOR]

Abstract: Left atrial (LA) volume reflects left ventricular (LV) diastolic properties. The latter is an important determinant of exercise capacity in patients with normal LV systolic function. We hypothesized that LA volume predicts exercise capacity in patients with isolated LV diastolic dysfunction. Echocardiography and treadmill exercise testing were performed in 256 patients with normal LV systolic function (ejection fraction≥50%). Diastolic dysfunction was defined using standard Doppler criteria. LA volume was measured using the ellipsoid method and indexed to the body surface area. 119 patients had LV diastolic dysfunction. They had higher indexed maximum LA volume (LA Volmax, p =0.004) and lower exercise capacity (p <0.001). Univariate predictors of exercise capacity were age, mitral E / A, E wave deceleration time, ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity (E /Ea), and indexed LA Volmax. On multivariate analysis, only age, mitral E / A and indexed LA Volmax were independent predictors of exercise capacity. Notably, the combination of LV diastolic dysfunction and enlarged LA Volmax predicted worse exercise intolerance. In conclusion, indexed LA volume is an independent and reliable predictor of exercise capacity in patients with isolated LV diastolic dysfunction. [ABSTRACT FROM AUTHOR]