Left ventricular diastolic function in hypertrophic cardiomyopathy: assessment by radionuclide angiography

Diastolic left ventricular function was studied in 20 patients with obstructive hypertrophic cardiomyopathy, 10 with apical hypertrophic cardiomyopathy, and 20 control subjects. The left ventricular time-activity curve was filtered using Fourier expansion with 4 harmonics. The first and second derivatives of the filtered curve were used to define various parameters of the left ventricle. Isovolumic relaxation period and time to peak filling rate were prolonged in obstructive hypertrophic cardiomyopathy and apical hypertrophic cardiomyopathy (101.56 +/- 44.81 msec, 105.19 +/- 45.27 versus 72.19 +/- 29.36 (CS) P less than 0.05; 169.70 +/- 50.73 msec, 173.83 +/- 50.53 versus 138.02 +/- 29.54 (CS) P less than 0.05, respectively). Rapid filling period, diastasis, atrial contraction period, time to peak filling rate-isovolumic relaxation period, and filling fraction of diastasis were not significantly different in these groups. Fasting filling fraction was 11% lower in hypertrophic groups than in control subjects. The filling fraction of atrial contribution was 12% higher in hypertrophic groups. We conclude: Isovolumic relaxation period, rapid filling phase, and diastasis atrial contraction period can be clearly defined by this technique. Impaired relaxation is an important determinant of decreased left ventricular filling in patients with obstructive hypertrophic cardiomyopathy and apical hypertrophic cardiomyopathy. Prolonged time to peak filling rate is mainly due to increased isovolumic relaxation period in hypertrophic patients. Atrial contraction contributes to more stroke volume in patients with hypertrophic cardiomyopathy.