ASSESSMENT OF ECHOCARDIOGRAPHIC LEFT-VENTRICULAR MASS BEFORE AND AFTER ACUTE VOLUME DEPLETION

Left ventricular mass calculations are often performed to assess the n eed or effectiveness of antihypertensive drug therapy. However, there are multiple potential errors that may affect the accuracy of these ca lculations, which can possibly include acute changes in preload. There fore, to assess the hypothesis that acute volume depletion might alter calculated left ventricular mass, 15 normotensive healthy male volunt eers underwent standard M-mode echocardiographic evaluations (at the l evel of the chordae tendineae guided by two-dimensional echocardiograp hy) before and 2 h after 40 mg of intravenous furosemide. One patient was eliminated due to hypotension prior to the final echocardiogram. T he echocardiograms were blinded to patient identity and the time seque nce and read separately by two investigators. Four to five cycles were read per echocardiogram by each investigator. All values measured wer e the mean of the two investigators. Echocardiographic measurements we re derived by both the American Society of Echocardiography and Penn c onventions. An average urine volume of 1728 mt was collected, and the mean weight change 2 h after furosemide administration was 1.78 kg (P = .001). Penn left ventricular diastolic diameter (1.8 mm, P = .015) a nd left ventricular mass index (10 g/m(2), P = .04) were significantly decreased; however, there was no significant change in septal, poster ior, or relative wall thicknesses. As it is unreasonable to believe th at acute remodeling of the left ventricle resulted in a decline in lef t ventricular mass in 2 hours, it is concluded that acute volume chang es resulted in a decrease in left ventricular mass measurement due to the influence of diastolic diameter on the calculation of cardiac mass .