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Is muscle mass increased in eccentric hypertrophy

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"eccentric hypertrophy" AND "left ventricular mass"

Reading File
Yes. In eccentric hypertrophy, total left ventricular (LV) mass increases. Wall thickness stays relatively normal because the chamber dilates.
Mechanism
  • Eccentric hypertrophy is the response to volume overload, for example aortic or mitral regurgitation.
  • Increased diastolic wall stress makes myocytes add sarcomeres in series. The myocytes lengthen, and the ventricle dilates. - Braunwald's Heart Disease (Cardiac Myocyte Hypertrophy)
  • Morgan and Mikhail's Clinical Anesthesiology says the same: sarcomeres replicate mainly in series, giving eccentric hypertrophy. The larger end-diastolic volume helps keep resting stroke volume and cardiac output normal.
Echo definitions
  • Eccentric hypertrophy: increased LV mass with normal relative wall thickness.
  • Concentric hypertrophy: increased LV mass with increased relative wall thickness. This is typical of pressure overload, as in aortic stenosis.
  • Concentric remodeling: normal LV mass with increased relative wall thickness. This is typical of hypertensive heart disease.
  • The echocardiography text describes eccentric hypertrophy as "a dilated chamber with normal wall thickness but an increased total weight of the ventricle." - Textbook of Clinical Echocardiography (Left Ventricular Geometry and Mass)
Why wall thickness can mislead The wall looks normal because it is spread around a bigger cavity, so wall thickness alone underestimates the muscle gained. Mass is calculated from both cavity size and wall thickness. That is why LV mass is increased even though the walls are not thick.
A quick PubMed check for recent systematic reviews and meta-analyses found nothing that contradicts this. The results were on LVH prevalence and imaging, for example PMID 42554265.
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