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

Núñez, Juana; Zamorano, José Luís; Isla, Leopoldo Pérez de; Palomeque, C. Fernandez; Almerı́a, Carlos; Rodrigo, José Luis; Corteza, José; Banchs, José; Macaya, Carlos

doi:10.1016/j.echo.2004.03.029

Cited by 27 publications

(30 citation statements)

References 16 publications

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“…50 In hypertensive patients older than 70 years of age, 51 LV contractility may be impaired at stress possibly as the result of myocardial fibrosis compared with the relatively younger groups. 32,44,45 It has been reported that AT1 receptor blocker agent used in this subset of patients may lead to a decrease in destruction of cardiomyocytes and halt the progressive fibrosis. 52,53 HFPEF is the relatively new clinical entity, and almost half of total HF patients have a LV EF of at least 45%.…”

Section: Sympathetic Stimulation and Dynamics In Hypertension-mediatementioning

confidence: 99%

“…44,45 Our comparison analysis of patients with hypertensive LVH versus cardiomyopathy through real-time three-dimensional echocardiography of mitral annular circumferential and longitudinal motions, which reflect global LV function, are preserved in patients with hypertensive LVH unlike those with cardiomyopathy. 45 Cardiac tissue energy metabolism has been found to be unchanged at the LVH stage of pressure-overload model before HF development in Dahl salt-sensitive rats.…”

Section: Sympathetic Stimulation and Dynamics In Hypertension-mediatementioning

confidence: 99%

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Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients

Yalçın

Küçukler

et al. 2010

J Hum Hypertens

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Excessive sympathetic activity and stress-induced left ventricular (LV) hypercontractility have been described in hypertensive LV hypertrophy. Recent quantitative data have shown that hypertensive LV hypertrophy is associated with preserved global LV function. However, progression of uncontrolled hypertension have detrimental effects on both the ejection fraction (EF) and LV contractile response to stress. Hypertensive LV hypertrophy has some common characteristics, including preserved global LV systolic function and LV volume with heart failure with preserved EF (HFPEF), which makes it difficult to differentiate between the two conditions at rest. Studies suggest that adopting an efficient antihypertensive therapy regimen may positively effect on the LV contractile capability in patients with long-standing hypertension. Evaluation of quantitative LV contractility under stress may be beneficial to differentiate between the hypertensive LV hypertrophy and HFPEF. It may also assist in developing a more effective modality in medical management of patients with hypertensive heart disease.

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Section: Sympathetic Stimulation and Dynamics In Hypertension-mediatementioning

confidence: 99%

Section: Sympathetic Stimulation and Dynamics In Hypertension-mediatementioning

confidence: 99%

Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients

Yalçın

Küçukler

et al. 2010

J Hum Hypertens

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“…In addition, the Global Function Index (GFI), which has been previously proposed for the distinction of pathologic and physiologic LVH [20,21], was calculated. The GFI is defined as ratio between diastolic parameters (early mitral inflow velocity [E]/ early mitral annulus velocity [E 0 ]) and the peak systolic mitral annulus (MA) velocity [S 0 ]: GFI = (E/ E 0 )/S 0 [s 9 cm -1 ].…”

Section: Echocardiographic Examinationmentioning

confidence: 99%

“…The GFI is defined as ratio between diastolic parameters (early mitral inflow velocity [E]/ early mitral annulus velocity [E 0 ]) and the peak systolic mitral annulus (MA) velocity [S 0 ]: GFI = (E/ E 0 )/S 0 [s 9 cm -1 ]. A GFI [ 1.77 was reported as strongly suggesting the diagnosis of HCM in the presence of LVH [20,21].…”

Section: Echocardiographic Examinationmentioning

confidence: 99%

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Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy

Butz

Buuren

Mellwig

et al. 2010

Int J Cardiovasc Imaging

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Two-dimensional strain (2DS) is a novel method to measure strain from standard two-dimensional echocardiographic images by speckle tracking, which is less angle dependent and more reproducible than conventional Doppler-derived strain. The objective of our study was to characterize global and regional function abnormalities using 2DS and strain rate analysis in patients (pts) with pathological left ventricular hypertrophy (LVH) caused by non-obstructive hypertrophic cardiomyopathy (HCM), in top level athletes, and in healthy controls. The hypothetical question was, if 2DS might be useful as additional tool in differentiating between pathologic and physiologic hypertrophy in top-level athletes. We consecutively studied 53 subjects, 15 pts with hypertrophic cardiomyopathy (HCM), 20 competitive top-level athletes, and a control group of 18 sedentary normal subjects by standard echocardiography according to ASE guidelines. Global longitudinal strain (GLS) and regional peak systolic strain (PSS) was assessed by 2DS in the apical four-chamber-view using a dedicated software. All components of strain were significantly reduced in pts with HCM (GLS: -8.1 ± 3.8%; P < 0.001) when compared with athletes (-15.2 ± 3.6%) and control subjects (-16.0 ± 2.8%). In general, there was no significant difference between the strain values of the athletes and the control group, but in some of the segments, the strain values of the control group were significantly higher than those in the athletes. A cut-off value of GLS less than -10% for the diagnosis of pathologic hypertrophy (HCM) resulted in a sensitivity of 80.0% and a specificity of 95.0%. The combination of TDI (averaged S', E') and 2DS (GLS) cut-off values for the detection of pathologic LVH in HCM demonstrated a sensitivity of 100%, and a specificity of 95%. Two-dimensional strain is a new simple and rapid method to measure GLS and PSS as components of systolic strain. This technique could offer a unique approach to quantify global as well as regional systolic dysfunction, and might be used as new additional tool for the differentiation between physiologic and pathologic LVH.

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Early segmental relaxation abnormalities in hypertrophic cardiomyopathy for differential diagnostic of patients with left ventricular hypertrophy

Voigt¹,

Münch²,

Avanesov

et al. 2017

Clinical Cardiology

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Background Hypertrophic cardiomyopathy (HCM) is characterized by asymmetric left ventricular hypertrophy (LVH). However, clinical signs can be subtle and differentiation from other causes of LVH is challenging. Hypothesis As diastolic dysfunction (DD) is an early sign in HCM, we aimed to find regional changes in relaxation pattern for differentiation from other entities of LVH. Methods In 148 patients (81 HCM, 55 arterial hypertension (AHT), 12 Fabry disease) and 63 healthy controls, relaxation patterns were assessed using regional tissue Doppler imaging. In 42 HCM patients, myocardial mass and fibrosis were quantified by cardiac magnetic resonance imaging and correlated with relaxation parameters. Results In HCM the septal to lateral isovolumic relaxation time (s/l IVRT) ratio was higher (1.5 ± 0.4) compared with AHT (1.1 ± 0.2), Fabry disease (1.0 ± 0.1), and controls (1.1 ± 0.2; P < 0.001), showing 77% sensitivity and 79% specificity to discriminate HCM‐related LVH from other entities. The s/l IVRT ratio was independent of global DD in HCM (HCM with DD: 1.5 ± 0.5, n = 52; HCM without DD: 1.5 ± 0.3, n = 29) and remained significantly different from other entities in a subgroup of HCM patients with maximum wall thickness < 20 mm (s/l ratio: 1.5 ± 0.5, n = 28). Regional IVRT did not correlate with the corresponding segmental myocardial mass or amount of fibrosis in cardiac magnetic resonance imaging. Conclusions HCM patients show a prolonged septal IVRT irrespective of the extent of LVH and even before developing global DD. The s/l IVRT ratio is significantly higher in HCM compared with AHT or Fabry disease, thus establishing segmental IVRT analysis as a potential parameter for differential diagnosis in LVH.

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

Cited by 27 publications

References 16 publications

Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients

Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients

Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy

Early segmental relaxation abnormalities in hypertrophic cardiomyopathy for differential diagnostic of patients with left ventricular hypertrophy

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