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Relation between extent of left ventricular hypertrophy and diastolic filling abnormalities in hypertrophic
1Echocardiography Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892.
Insights
Diastolic dysfunction is common in hypertrophic cardiomyopathy, but Doppler echocardiography shows no correlation between diastolic impairment and left ventricular hypertrophy severity.
Area of Science:
- Cardiology
- Cardiovascular Imaging
Background:
- Left ventricular diastolic impairment is a key feature of hypertrophic cardiomyopathy.
- The relationship between diastolic dysfunction severity and the degree of left ventricular hypertrophy remains unclear.
Purpose of the Study:
- To compare Doppler echocardiographic indices of diastolic filling in patients with hypertrophic cardiomyopathy versus controls.
- To assess the correlation between diastolic filling abnormalities and the magnitude of left ventricular hypertrophy.
Main Methods:
- Doppler echocardiography was used to evaluate diastolic filling in 78 hypertrophic cardiomyopathy patients and 72 controls.
- Key indices assessed included isovolumic relaxation time, early and late diastolic flow velocities, and deceleration time.
Main Results:
- Patients with hypertrophic cardiomyopathy exhibited prolonged isovolumic relaxation, reduced early diastolic flow velocity, and impaired deceleration compared to controls.
- Diastolic filling abnormalities were present in 67% of hypertrophic cardiomyopathy patients.
- No significant correlation was found between Doppler diastolic indices and maximal left ventricular wall thickness or wall thickness index.
Conclusions:
- Diastolic dysfunction is prevalent in hypertrophic cardiomyopathy.
- The severity of left ventricular hypertrophy does not correlate with the degree of diastolic impairment in hypertrophic cardiomyopathy.
Abstract:
In hypertrophic cardiomyopathy, the relation between left ventricular diastolic impairment and magnitude of left ventricular hypertrophy has not been clearly defined. In the present study, Doppler echocardiographic indexes of left ventricular diastolic filling were compared in 78 patients with hypertrophic cardiomyopathy and in 72 normal control subjects of similar age, and the relation between abnormalities of diastolic filling and magnitude of left ventricular hypertrophy was assessed. In patients with hypertrophic cardiomyopathy, isovolumic relaxation was prolonged (94 +/- 25 ms); peak early diastolic flow velocity (53 +/- 18 cm/s), deceleration of flow velocity in early diastole (341 +/- 142 cm/s2) and the ratio between early and late peaks of flow velocity (1.6 +/- 0.9) were reduced; and peak late diastolic flow velocity was increased (38 +/- 15 cm/s) compared with values in control subjects (76 +/- 12 ms, 65 +/- 12 cm/s, 512 +/- 131 cm/s2, 2.3 +/- 0.8 and 30 +/- 7 cm/s, respectively; p less than 0.001). Individual patient analysis showed that diastolic filling was abnormal in 52 (67%) of the 78 patients with hypertrophic cardiomyopathy. However, within the patient group, none of the Doppler diastolic indexes showed a significant correlation with maximal left ventricular wall thickness or the wall thickness index (correlation coefficients ranged from -0.15 to 0.10).(ABSTRACT TRUNCATED AT 250 WORDS)