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Background: Hypertrophic cardiomyopathy (HCM) is the most common type of the genetic cardiovasculardiseases. Regarding to tremendous heterogeneity in the phenotypic expression of HCM, which is generally unrelatedto genotype, we aimed to study, clinical and echocardiographic parameters such as Tissue Doppler Imaging(TDI) in various subtypes of HCM p...
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... con- traction, in the 9 segments (Base septal, Mid septal, Base Lateral, Mid Lateral, Base Infe- rior, Mid Inferior, Base Anterior, Mid Anterior, Mid Anteroseptal). Early diastolic annular ve- locity (Em) was obtained by placing a tissue Doppler sample volume at the septal mitral an- nulus in the 4 -chamber view, and E/Em ratio was calculated (Fig. ...
Citations
Background: The distribution and magnitude of left ventricular hypertrophy (LVH) are not uniform in patients with hypertrophic cardiomyopathy (HCM), which results in regional heterogeneity of left ventricular (LV) systolic function. The aim of this study was to evaluate LV regional systolic dyssynchrony in patients with HCM by Tissue Doppler Imaging (TDI) and to find any correlation between TDI data and syncope. Methods: A total of 44 consecutive patients with HCM are recruited in the present study.All patients, underwent complete clinical and echocardiographic evaluation including TDI. The following were measured in 6 different basal and 6 mid-myocardial segments: systolic peak velocity(Sm), early diastolic myocardial velocity (Em), pre-contraction time(Q-Sm) from beginning of Q-wave of ECG to the onset of Sm, total asynchrony index,interventricular mechanical delay(difference in Q-Aortic valve opening and Q-Pulmonic valve opening) and maximum difference in time to peak systolic velocity between 2 of 12 segments(ΔPVI). Results: TDI analysis in HCM subgroup with syncope showed both significant interventricular (36.72±26.26 vs 14.74±11.30 msec, P<0.001) and intraventricular delays(39.40±22.38 vs27.70±17.32 msec, P=0.07). The prevalence of LV systolic dyssynchrony was from 20.5% to 38.6% based on different methods. Patients with syncope had greater impairment of regional systolic and early diastolic function, remarkably lower Sm and Em velocities. Conclusion: The impairment of inter and intraventricular systolic synchronicity is significantly related to syncope in patients with HCM.TDI analysis may be able to select subgroups of HCM patients at increasing risk of syncope and major cardiac events.
Introduction: Multimodality imaging can help rule in/out the diagnosis of hypertrophic cardiomyopathy (HCM) in patients with significant left ventricular (LV) hypertrophy. Case Presentation: We describe a 73-year-old woman referred to us for consultation because of a giant negative T wave on her electrocardiography. Echocardiography revealed diffuse severe hypertrophy associated with hypertrophied anterolateral papillary muscles with a bifid head and with extensive wall insertion into the apicolateral segment. Three-dimensional echocardiography and cardiac magnetic resonance confirmed these data. Importantly, automated function imaging determined the global longitudinal strain at-10.2%. Conclusions: According to our multimodality imaging approach, hypertrophic cardiomyopathy was the most probable diagnosis.
