Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography

Tomoko S. Kato, Akiko Noda, Hideo Izawa, Akira Yamada, Koji Obata, Kohzo Nagata, Mitsunori Iwase, Toyoaki Murohara, Mitsuhiro Yokota

Research output: Contribution to journalArticle

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Abstract

Background-The differentiation of hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) on the basis of morphological information obtained by conventional echocardiography is occasionally problematic. We investigated whether strain rate (SR) imaging derived from tissue Doppler imaging (TDI) is able to discriminate HCM from H-LVH. Methods and Results-Conventional echocardiography and TDI were performed with 34 patients with LVH and 16 reference subjects. Mean values of systolic strain (εsys), peak systolic SR, and early diastolic SR obtained from 8 left ventricular (LV) segments were calculated. LV pressures were recorded simultaneously in the patients. Patients were diagnosed with HCM (n=20) or H-LVH (n=14) on the basis of conventional echocardiography and endomyocardial biopsy findings. Multivariate analysis revealed that septum/posterior wall thickness ratio (P=0.00013) and εsys (P<0.0001) were each able to discriminate HCM from H-LVH. A εsys cutoff value of - 10.6% discriminated between HCM and H-LVH with a sensitivity of 85.0%, specificity of 100.0%, and predictive accuracy of 91.2%. The combination of the septum/posterior wall thickness ratio and εsys discriminated HCM from H-LVH with a predictive accuracy of 96.1%. The εsys parameter was significantly correlated with pulmonary arterial wedge pressure, LV end-diastolic pressure, the peak positive first derivative of LV pressure, and the time constant of LV pressure decay. Conclusions-SR imaging is able to discriminate HCM from H-LVH, with εsys reflecting myocardial contractile and lusitropic properties.

Original languageEnglish
Pages (from-to)3808-3814
Number of pages7
JournalCirculation
Volume110
Issue number25
DOIs
Publication statusPublished - 21-12-2004

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Doppler Ultrasonography
Hypertrophic Cardiomyopathy
Left Ventricular Hypertrophy
Ventricular Pressure
Echocardiography
Pulmonary Wedge Pressure
Doppler Echocardiography
Arterial Pressure
Multivariate Analysis
Blood Pressure
Biopsy
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Kato, Tomoko S. ; Noda, Akiko ; Izawa, Hideo ; Yamada, Akira ; Obata, Koji ; Nagata, Kohzo ; Iwase, Mitsunori ; Murohara, Toyoaki ; Yokota, Mitsuhiro. / Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. In: Circulation. 2004 ; Vol. 110, No. 25. pp. 3808-3814.
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abstract = "Background-The differentiation of hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) on the basis of morphological information obtained by conventional echocardiography is occasionally problematic. We investigated whether strain rate (SR) imaging derived from tissue Doppler imaging (TDI) is able to discriminate HCM from H-LVH. Methods and Results-Conventional echocardiography and TDI were performed with 34 patients with LVH and 16 reference subjects. Mean values of systolic strain (εsys), peak systolic SR, and early diastolic SR obtained from 8 left ventricular (LV) segments were calculated. LV pressures were recorded simultaneously in the patients. Patients were diagnosed with HCM (n=20) or H-LVH (n=14) on the basis of conventional echocardiography and endomyocardial biopsy findings. Multivariate analysis revealed that septum/posterior wall thickness ratio (P=0.00013) and εsys (P<0.0001) were each able to discriminate HCM from H-LVH. A εsys cutoff value of - 10.6{\%} discriminated between HCM and H-LVH with a sensitivity of 85.0{\%}, specificity of 100.0{\%}, and predictive accuracy of 91.2{\%}. The combination of the septum/posterior wall thickness ratio and εsys discriminated HCM from H-LVH with a predictive accuracy of 96.1{\%}. The εsys parameter was significantly correlated with pulmonary arterial wedge pressure, LV end-diastolic pressure, the peak positive first derivative of LV pressure, and the time constant of LV pressure decay. Conclusions-SR imaging is able to discriminate HCM from H-LVH, with εsys reflecting myocardial contractile and lusitropic properties.",
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Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. / Kato, Tomoko S.; Noda, Akiko; Izawa, Hideo; Yamada, Akira; Obata, Koji; Nagata, Kohzo; Iwase, Mitsunori; Murohara, Toyoaki; Yokota, Mitsuhiro.

In: Circulation, Vol. 110, No. 25, 21.12.2004, p. 3808-3814.

Research output: Contribution to journalArticle

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T1 - Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography

AU - Kato, Tomoko S.

AU - Noda, Akiko

AU - Izawa, Hideo

AU - Yamada, Akira

AU - Obata, Koji

AU - Nagata, Kohzo

AU - Iwase, Mitsunori

AU - Murohara, Toyoaki

AU - Yokota, Mitsuhiro

PY - 2004/12/21

Y1 - 2004/12/21

N2 - Background-The differentiation of hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) on the basis of morphological information obtained by conventional echocardiography is occasionally problematic. We investigated whether strain rate (SR) imaging derived from tissue Doppler imaging (TDI) is able to discriminate HCM from H-LVH. Methods and Results-Conventional echocardiography and TDI were performed with 34 patients with LVH and 16 reference subjects. Mean values of systolic strain (εsys), peak systolic SR, and early diastolic SR obtained from 8 left ventricular (LV) segments were calculated. LV pressures were recorded simultaneously in the patients. Patients were diagnosed with HCM (n=20) or H-LVH (n=14) on the basis of conventional echocardiography and endomyocardial biopsy findings. Multivariate analysis revealed that septum/posterior wall thickness ratio (P=0.00013) and εsys (P<0.0001) were each able to discriminate HCM from H-LVH. A εsys cutoff value of - 10.6% discriminated between HCM and H-LVH with a sensitivity of 85.0%, specificity of 100.0%, and predictive accuracy of 91.2%. The combination of the septum/posterior wall thickness ratio and εsys discriminated HCM from H-LVH with a predictive accuracy of 96.1%. The εsys parameter was significantly correlated with pulmonary arterial wedge pressure, LV end-diastolic pressure, the peak positive first derivative of LV pressure, and the time constant of LV pressure decay. Conclusions-SR imaging is able to discriminate HCM from H-LVH, with εsys reflecting myocardial contractile and lusitropic properties.

AB - Background-The differentiation of hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) on the basis of morphological information obtained by conventional echocardiography is occasionally problematic. We investigated whether strain rate (SR) imaging derived from tissue Doppler imaging (TDI) is able to discriminate HCM from H-LVH. Methods and Results-Conventional echocardiography and TDI were performed with 34 patients with LVH and 16 reference subjects. Mean values of systolic strain (εsys), peak systolic SR, and early diastolic SR obtained from 8 left ventricular (LV) segments were calculated. LV pressures were recorded simultaneously in the patients. Patients were diagnosed with HCM (n=20) or H-LVH (n=14) on the basis of conventional echocardiography and endomyocardial biopsy findings. Multivariate analysis revealed that septum/posterior wall thickness ratio (P=0.00013) and εsys (P<0.0001) were each able to discriminate HCM from H-LVH. A εsys cutoff value of - 10.6% discriminated between HCM and H-LVH with a sensitivity of 85.0%, specificity of 100.0%, and predictive accuracy of 91.2%. The combination of the septum/posterior wall thickness ratio and εsys discriminated HCM from H-LVH with a predictive accuracy of 96.1%. The εsys parameter was significantly correlated with pulmonary arterial wedge pressure, LV end-diastolic pressure, the peak positive first derivative of LV pressure, and the time constant of LV pressure decay. Conclusions-SR imaging is able to discriminate HCM from H-LVH, with εsys reflecting myocardial contractile and lusitropic properties.

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