Doppler tissue imaging: Regional myocardial function in hypertrophic cardiomyopathy and in athlete's heart

Cardim, Nuno; Oliveira, António G.; Longo, Susana; Ferreira, Teresa; Pereira, Amadeu; Reis, Roberto Palma dos; Correia, J.

doi:10.1067/mje.2003.13

Cited by 97 publications

(65 citation statements)

References 68 publications

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“…The complexity of diagnosis of HCM is clinically problematic [1,2]. One form of HCM termed the "athletic heart" [3] is characterized by both cardiac tissue and cardiovascular system adaptations which allow intense exercise to be sustained for prolonged periods of time, such as a marathon or triathlon, or for intermittent sports such as basketball or ice hockey.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Mechanical Cardiac Function in Elite Athletes

Neary¹,

MacQuarrie²,

Jamnik³

et al. 2011

TOSMJ

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Hypertrophic cardiomyopathy (HCM) is the number one cause of sudden cardiac death in elite athletes. This project used resting 12-lead electrocardiography (ECG) and ballistocardiography (BCG) to assess cardiac cycle timing events as simple screening techniques to rule out cardiac abnormalities for the safety of a group of elite ice hockey players. Clinical cardiac (ECG) and physiological (maximal aerobic power [VO 2 max], anaerobic [Wingate peak power, Watts] and musculoskeletal strength) data is presented here on an elite group of ice hockey players (n=34; age=17-18 yrs) that participated in a professional medical and fitness evaluation. Subsequently one subject was diagnosed with #1 Apical HCM and his cardiac data is compared with the group. The HCM subject performed all fitness testing and was determined to be physically fit (%BF=7.2%; VO 2 max=59.4 mL•kg -1 •min -1 ; Wingate peak power output=15.1 Watt•kg -1 ; Heart Rate max=200 beats•min -1 ). However, the ECG showed extreme voltage and deeply inverted T-waves, and the BCG showed abnormal waveform complexes and cardiac timing events in comparison to the group means. Mean BCG systolic timing events for isovolumic contraction time ) and LV ejection fraction (62%). Cardiac magnetic resonance imaging (MRI) showed apical septal wall thickness (24-25 mm) in the HCM player. In conclusion, BCG was able to corroborate a cardiac abnormality that was later confirmed with echocardiography and MRI, suggesting that BCG is a potential technology to detect anomalies that alter cardiac timing and amplitude.

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Section: Introductionmentioning

confidence: 99%

Assessment of Mechanical Cardiac Function in Elite Athletes

Neary¹,

MacQuarrie²,

Jamnik³

et al. 2011

TOSMJ

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“…To our knowledge, there has been no report investigating abnormalities in the timing of systolic strain rate in patients with HCM while a few reports have indirectly assessed the timing of [5,23]. In contrast, Cardim et al reported the shortening of the time from mitral valve closure to the peak systolic mitral annular velocity [6]. The time between the onset of electrical systole and mechanical systole was shown to be prolonged in HCM patients [23], and this might be the cause of the above discrepancy.…”

Section: Comparison With the Previous Studiesmentioning

confidence: 99%

“…Although the left ventricular (LV) ejection fraction is usually preserved or increased in patients with hypertrophic cardiomyopathy (HCM) [1][2][3], reduced myocardial contraction, especially in the longitudinal direction, has been observed in HCM patients by tissue Doppler imaging (TDI) [4][5][6], Doppler strain-rate imaging [7] and 2-dimensional speckle tracking echocardiography (STE) [8][9][10]. On the other hand, there have been few reports on alterations in the timing of the systolic peak and the systolic waveform of the LV myocardial strain rate in patients with HCM.…”

Section: Introductionmentioning

confidence: 99%

Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy

et al. 2016

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We analyzed the waveform of systolic strain and strain-rate curves to find a characteristic left ventricular (LV) myocardial contraction pattern in patients with hypertrophic cardiomyopathy (HCM), and evaluated the utility of these parameters for the differentiation of HCM and LV hypertrophy secondary to hypertension (HT). From global strain and strain-rate curves in the longitudinal and circumferential directions, the time from mitral valve closure to the peak strains (T-LS and T-CS, respectively) and the peak systolic strain rates (T-LSSR and T-CSSR, respectively) were measured in 34 patients with HCM, 30 patients with HT and 25 control subjects. The systolic strain-rate waveform was classified into 3 patterns ("V", "W", and "√" pattern). In the HCM group, T-LS was prolonged, but T-LSSR was shortened; consequently, T-LSSR/T-LS ratio was distinctly lower than in the HT and control groups. The "√" pattern of longitudinal strain-rate waveform was more frequently seen in the HCM group (74%) than in the control (4%) and HT (20%) groups. Similar but less distinct results were obtained in the circumferential direction. To differentiate HCM from HT, the sensitivity and specificity of the T-LSSR/T-LS ratio <0.34 and the "√"-shaped longitudinal strain-rate waveform were 85% and 63%, and 74% and 80%, respectively. In conclusion, in patients with HCM, a reduced T-LSSR/T-LS ratio and a characteristic "√"-shaped waveform of LV systolic strain rate was seen, especially in the longitudinal direction. The timing and waveform analyses of systolic strain rate may be useful to distinguish between HCM and HT.

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“…In HCM with normal ejection fraction, there was reduction in systolic myocardial velocity (S'), even in segments not presenting hypertrophy 55 . The early diastolic velocity (E') is diminished and .…”

Section: Tissue Dopplermentioning

confidence: 99%

O diagnóstico da obstrução da via de saída do ventrículo esquerdo na cardiomiopatia hipertrófica

Mattos¹,

Torres²,

Rebelatto³

et al. 2012

Arq. Bras. Cardiol.

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Hypertrophic cardiomyopathy is a prevalent genetic disease characterized by left ventricular hypertrophy, presenting dynamic obstruction of outflow tract with subaortic gradient happening at rest in 30% of the cases. It is attributed to the intricate interaction between the anterior mitral leaflet, the interventricular septum and altered flow vectors generated in left ventricle along with changes in outflow tract geometry. Mitral regurgitation in varying degrees is found with or without association with structural deformities of the valve apparatus. The exercise echocardiogram evidences latent obstruction easily induced by exercise in 60 to 75% of nonobstructive forms. The determination of the gradient under this condition must be considered in routine investigation of patients with mild or no obstruction at rest. The evaluation of hypertrophic cardiomyopathy incorporates methods based on the ultrasound image, which, along with MRI, allow recognizing ventricular obstruction generating mechanisms, thus facilitating the diagnosis and management of obstructive and latent obstructive forms.

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Doppler tissue imaging: Regional myocardial function in hypertrophic cardiomyopathy and in athlete's heart

Cited by 97 publications

References 68 publications

Assessment of Mechanical Cardiac Function in Elite Athletes

Assessment of Mechanical Cardiac Function in Elite Athletes

Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy

O diagnóstico da obstrução da via de saída do ventrículo esquerdo na cardiomiopatia hipertrófica

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