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Combined echo-apexcardiographic assessment of left ventricular function in cardiomyopathy
Insights
This study shows that combining M-mode echocardiography and apex cardiography can effectively assess cardiac performance in hypertrophic obstructive cardiomyopathy (HOCM) and congestive cardiomyopathy (COCM) noninvasively. These combined methods offer a new approach to understanding heart function in these conditions.
Area of Science:
- Cardiology
- Biomedical Engineering
- Diagnostic Imaging
Background:
- Cardiomyopathy diagnosis often relies on invasive methods.
- Noninvasive techniques are crucial for patient monitoring and management.
- Assessing cardiac performance requires evaluating both systolic and diastolic functions.
Purpose of the Study:
- To evaluate the utility of combined M-mode echocardiography and apex cardiography for noninvasive assessment of cardiac performance.
- To differentiate between hypertrophic obstructive cardiomyopathy (HOCM) and congestive cardiomyopathy (COCM) using these noninvasive parameters.
- To correlate noninvasive findings with established invasive measures of cardiac function.
Main Methods:
- Simultaneous recording and calibration of left apex cardiogram and M-mode echogram.
- Noninvasive measurement of mean normalized velocity of circumferential fiber shortening (VCFS), mean normalized velocity of circumferential fiber lengthening (VCFL), and left ventricular diastolic distensibility.
- Comparison of measurements in patients with HOCM, COCM, and healthy controls.
Main Results:
- HOCM patients showed increased VCFS and decreased VCFL and diastolic distensibility compared to controls.
- COCM patients exhibited diminished VCFS, VCFL, and diastolic distensibility compared to controls.
- Noninvasive echo-apexcardiographic indexes correlated significantly with analogous invasive indexes.
Conclusions:
- Combined M-mode echocardiography and apex cardiography provide a valuable noninvasive method for studying cardiac performance in cardiomyopathy.
- This combined approach offers a novel strategy for assessing HOCM and COCM.
- The noninvasive assessment of cardiac function is enhanced by integrating echocardiography and apex cardiography.
Abstract:
Eleven patients with hypertrophic obstructive cardiomyopathy (HOCM) and 9 patients with congestive cardiomyopathy (COCM) were studied to determine the usefulness of mean normalized velocity of circumferential fiber shortening (VCFS), mean normalized velocity of circumferential fiber lengthening (VCFL) and left ventricular diastolic distensibility obtained noninvasively from combined recordings of simultaneously calibrated left apex cardiogram and M-mode echogram. Twenty-two normal subjects were similarly investigated and served as a control. In HOCM VCFS were increased (1.83 +/- 0.2 s-1 versus 1.22 +/- 0.1 s-1 for controls, p less than 0.02) and both VCFL and diastolic distensibility were decreased (VCFL: 0.50 +/- 0.1 s-1 versus 1.32 s-1 in controls, p less than 0.001; diastolic distensibility: 0.03 +/- 0.004 cm/mmHg-1 compared with 0.18 +/- 0.003 cm/mmHg-1 for controls, p less than 0.001). In COCM all investigated indexes were diminished (VCFS: 0.49 +/- 0.1 s-1 versus 1.22 +/- 0.1 s-1 for controls, p less than 0.001; VCFL: 0.70 +/- 0.1 s-1 versus 1.32 +/- 0.1 s-1 in controls, p less than 0.01 and diastolic distensibility: 0.05 +/- 0.003 cm/mmHg-1 compared with 0.18 +/- 0.003 cm/mmHg-1 for controls, p less than 0.01). The echo-apexcardiographic indexes were significantly correlated with many analogous invasive indexes. It is concluded that the value of both M-mode echocardiography and calibrated apex cardiography is enchanced by a combination of the two methods which opens the possibility of a fresh approach to the noninvasive study of cardiac performance in cardiomyopathy.