Differences in regional systolic and diastolic function by Doppler tissue imaging in patients with hypertrophic cardiomyopathy and hypertrophy caused by hypertension.

摘要

OBJECTIVE: Doppler tissue (DT) velocity abnormalities have been described in patients with pathologic left ventricular hypertrophy (LVH). Impaired myocardial function has been suggested as a primary disorder in hypertrophic cardiomyopathy (HCM) and differences in DT parameters have been reported to be distinguishable from other LVH causes. We evaluated DT differences for patients with LVH caused by hypertension and patients with HCM, assessing regional systolic and diastolic function. METHODS: A total of 62 participants were studied: 21 with HCM; 22 with LVH secondary to hypertension; and 19 control subjects. DT was used to record mitral annulobasal segment motion in the longitudinal axis. Systolic and diastolic velocities were measured at lateral and septal sites, and well-known ratios were obtained for diastolic assessment. A new global function index (GFI) that evaluates both systole and diastole was also calculated (GFI = [Emi/E(DT)]/S(DT) [s x cm(-1)], where mi is mitral inflow, E is E wave, and Sis systolic wave). RESULTS: Comparison showed significant differences in all parameters evaluated at the septal-basal segment and a GFI value of 1.77 showed 85% sensitivity and 75% specificity for detecting HCM when interventricular septum thickness was increased. CONCLUSIONS: In the presence of unexplained LVH, markedly decreased DT velocities at basal septum efficiently detect myocardial dysfunction at this segment, and a calculated GFI > 1.77 strongly supports the diagnosis of HCM.