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Usefulness of a new proposed tissue Doppler imaging global function index in hypertrophic cardiomyopathy
Aloir Q Araujo1, Edmundo Arteaga, Barbara M Ianni
1Heart Institute (INCOR), University of São Paulo Medical School, São Paulo, Brazil. aloirqueiroz@cardiol.br
Insights
The global function index (GFI) shows potential for diagnosing hypertrophic cardiomyopathy (HCM), but its clinical use is limited by overlapping values between patient groups.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Hypertrophic cardiomyopathy (HCM) diagnosis can be challenging.
- Tissue Doppler imaging (TDI) offers advanced diagnostic tools.
- A global function index (GFI) has been proposed for HCM diagnosis.
Purpose of the Study:
- To evaluate the clinical utility of the global function index (GFI) in a large cohort of hypertrophic cardiomyopathy (HCM) patients.
- To assess the GFI's effectiveness in differentiating between HCM subtypes and healthy controls.
Main Methods:
- Calculated GFI using the formula [E/Ea]/Sa at mitral annulus borders.
- Analyzed GFI in 164 HCM patients and 40 healthy volunteers.
- Performed group comparisons and correlation analyses with clinical variables.
Main Results:
- GFI values showed significant differences between controls, obstructive HCM, and nonobstructive HCM (P < 0.0001).
- However, substantial overlap in GFI values was observed across these groups.
- GFI correlated with septal thickness, left atrial diameter, and left ventricle outflow tract (LVOT) gradient.
Conclusions:
- The GFI's asymmetrical distribution and overlapping values limit its diagnostic reliability in selected HCM populations.
- Further research is needed to establish the GFI's clinical validity and its role compared to other TDI indices.
Background:
A global function index (GFI) derived from tissue Doppler imaging (TDI) has been proposed to improve the diagnosis of hypertrophic cardiomyopathy (HCM). We aimed to evaluate the usefulness of this index in a large selected HCM population.
Methods:
GFI =[E/Ea]/Sa, was calculated at mitral annulus lateral and septal borders in 164 HCM patients and in 40 healthy volunteers. Group comparisons and correlations between GFI and other variables were performed.
Results:
Of the 164 patients, 69 (42%) had a peak gradient >30 mmHg in the left ventricle outflow tract (LVOT). GFI (lateral or septal) was not normally distributed. There were differences among controls, obstructive HCM, and nonobstructive HCM (P < 0.0001), but significant overlap of GFI values were observed between groups. GFI was correlated to septal thickness (r = 0.44; P < 0.0001), left atrial diameter (r = 0.52; P < 0.0001), and LVOT gradient (r = 0.58; P < 0.0001).
Conclusion:
In a selected HCM population, GFI was limited by its asymmetrical distribution and significant overlap of values between groups. Further studies are necessary to verify the reliability of GFI in the clinical practice and its position among other tissue Doppler indices.
