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Discrimination of Nonobstructive Hypertrophic Cardiomyopathy From Hypertensive Left Ventricular Hypertrophy on the Basis of Strain Rate Imaging by Tissue Doppler Ultrasonography
- Source :
- Circulation. 110:3808-3814
- Publication Year :
- 2004
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2004.
-
Abstract
- Background— The differentiation of hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) on the basis of morphological information obtained by conventional echocardiography is occasionally problematic. We investigated whether strain rate (SR) imaging derived from tissue Doppler imaging (TDI) is able to discriminate HCM from H-LVH. Methods and Results— Conventional echocardiography and TDI were performed with 34 patients with LVH and 16 reference subjects. Mean values of systolic strain (ε sys ), peak systolic SR, and early diastolic SR obtained from 8 left ventricular (LV) segments were calculated. LV pressures were recorded simultaneously in the patients. Patients were diagnosed with HCM (n=20) or H-LVH (n=14) on the basis of conventional echocardiography and endomyocardial biopsy findings. Multivariate analysis revealed that septum/posterior wall thickness ratio ( P =0.00013) and ε sys ( P sys cutoff value of −10.6% discriminated between HCM and H-LVH with a sensitivity of 85.0%, specificity of 100.0%, and predictive accuracy of 91.2%. The combination of the septum/posterior wall thickness ratio and ε sys discriminated HCM from H-LVH with a predictive accuracy of 96.1%. The ε sys parameter was significantly correlated with pulmonary arterial wedge pressure, LV end-diastolic pressure, the peak positive first derivative of LV pressure, and the time constant of LV pressure decay. Conclusions— SR imaging is able to discriminate HCM from H-LVH, with ε sys reflecting myocardial contractile and lusitropic properties.
- Subjects :
- Male
Cardiac Catheterization
medicine.medical_specialty
Heart disease
Biopsy
Cardiomyopathy
Sensitivity and Specificity
Doppler imaging
Muscle hypertrophy
symbols.namesake
Physiology (medical)
Internal medicine
medicine
Humans
Myocytes, Cardiac
Pulmonary Wedge Pressure
Cardiac Output
Aged
business.industry
Hypertensive left ventricular hypertrophy
Hypertrophic cardiomyopathy
Cardiomyopathy, Hypertrophic
Middle Aged
medicine.disease
Myocardial Contraction
Echocardiography, Doppler
Echocardiography, Doppler, Color
ROC Curve
Strain rate imaging
Hypertension
symbols
Cardiology
Female
Hypertrophy, Left Ventricular
Stress, Mechanical
Cardiology and Cardiovascular Medicine
business
Doppler effect
Endocardium
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 110
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....505e02607969bd7d797eb5bfcdfda59c