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Myocardial velocity gradient as a noninvasively determined index of left ventricular diastolic dysfunction in
Tomoko Kato1, Akiko Noda, Hideo Izawa
1Cardiovascular Division, Department of Clinical Pathophysiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan.
Insights
Peak negative myocardial velocity gradient (MVG) from tissue Doppler imaging (TDI) effectively assesses diastolic dysfunction in hypertrophic cardiomyopathy (HCM). A reduced MVG indicates prolonged relaxation and elevated left ventricular end-diastolic pressure (LVEDP), offering a noninvasive diagnostic tool.
Area of Science:
- Cardiology
- Echocardiography
- Diastology
Background:
- Hypertrophic cardiomyopathy (HCM) presents with impaired diastolic function, including abnormal stiffness and prolonged relaxation.
- Noninvasive evaluation of these diastolic defects in HCM remains challenging.
Purpose of the Study:
- To investigate the utility of peak negative myocardial velocity gradient (MVG) from tissue Doppler imaging (TDI) for assessing diastolic dysfunction in patients with HCM.
Main Methods:
- Tissue Doppler imaging (TDI) and conventional echocardiography were performed in 36 HCM patients and 47 controls.
- Left ventricular (LV) pressure was measured simultaneously in all HCM patients and 26 controls.
Main Results:
- Peak negative MVG was significantly lower in HCM patients (2.32 ± 0.52/s) compared to controls (4.82 ± 1.15/s), with a cutoff of 3.2/s differentiating the groups.
- HCM patients exhibited increased LV end-diastolic pressure (LVEDP) and prolonged isovolumic relaxation time constant (tau).
- Peak negative MVG showed a significant negative correlation with both LVEDP (r = -0.75) and tau (r = -0.58).
Conclusions:
- Reduced peak negative MVG reflects both prolonged relaxation and elevated LVEDP in HCM patients.
- Peak negative MVG serves as a potential noninvasive index for diastolic function.
- This parameter provides unique insights into auxotonic relaxation in HCM.
Objectives:
We investigated the utility of the peak negative myocardial velocity gradient (MVG) derived from tissue Doppler imaging (TDI) for evaluation of diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM).
Background:
Hypertrophic cardiomyopathy is characterized by impaired diastolic function with abnormal stiffness and prolonged relaxation. However, it remains difficult to evaluate these defects noninvasively.
Methods:
Both TDI and conventional echocardiography were performed in 36 patients with HCM and in 47 control subjects. Left ventricular (LV) pressure was measured simultaneously in all HCM patients and in 26 controls.
Results:
The peak negative MVG occurred soon after the isovolumic relaxation period during the initial phase of rapid filling (auxotonic relaxation). It was significantly smaller in HCM patients than in control subjects (2.32 +/- 0.52/s vs. 4.82 +/- 1.15/s, p < 0.0001); the cutoff value for differentiation between all HCM patients and 47 normal individuals was determined as 3.2/s. Both the left ventricular end-diastolic pressure (LVEDP) (19.6 +/- 6.1 mm Hg vs. 6.5 +/- 1.7 mm Hg, p < 0.0001) and the time constant of LV pressure decay during isovolumic diastole (tau) (44.0 +/- 6.7 ms vs. 32.1 +/- 5.5 ms, p < 0.0001) were increased in HCM patients compared with controls. The peak negative MVG was negatively correlated with both LVEDP (r = -0.75, p < 0.0001) and tau (r = -0.58, p < 0.0001).
Conclusions:
A reduced peak negative MVG reflects both prolonged relaxation and elevated LVEDP. The peak negative MVG might thus provide a noninvasive index of diastolic function, yielding unique information about auxotonic relaxation in patients with HCM.
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