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Yalçin F, Yalçin H, Küçükler N, Arslan S, Akkuş O, Kurtul A, Abraham MR. Basal Septal Hypertrophy as the Early Imaging Biomarker for Adaptive Phase of Remodeling Prior to Heart Failure. J Clin Med 2021; 11:75. [PMID: 35011816 PMCID: PMC8745483 DOI: 10.3390/jcm11010075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 01/19/2023] Open
Abstract
Hypertension plays a dominant role in the development of left ventricular (LV) remodeling and heart failure, in addition to being the main risk factor for coronary artery disease. In this review, we focus on the focal geometric and functional tissue aspects of the LV septal base, since basal septal hypertrophy (BSH), as the early imaging biomarker of LV remodeling due to hypertensive heart disease, is detected in cross-sectional clinic studies. In addition, the validation of BSH by animal studies using third generation microimaging and relevant clinical observations are also discussed in the report. Finally, an evaluation of both human and animal quantitative imaging studies and the importance of combined cardiac imaging methods and stress-induction in the separation of adaptive and maladaptive phases of the LV remodeling are pointed out. As a result, BSH, as the early imaging biomarker and quantitative follow-up of functional analysis in hypertension, could possibly contribute to early treatment in a timely fashion in the prevention of hypertensive disease progression to heart failure. A variety of stress stimuli in etiopathogenesis and the difficulty of diagnosing pure hemodynamic overload mediated BSH lead to an absence of the certain prevalence of this particular finding in the population.
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Affiliation(s)
- Fatih Yalçin
- Cardiology UCSF Health, Department of Medicine, University of California at San Francisco, San Francisco, CA 94143, USA; (H.Y.); (M.R.A.)
- Department of Cardiology, Mustafa Kemal University, Antakya 31100, Turkey; (N.K.); (S.A.); (O.A.); (A.K.)
| | - Hulya Yalçin
- Cardiology UCSF Health, Department of Medicine, University of California at San Francisco, San Francisco, CA 94143, USA; (H.Y.); (M.R.A.)
- Department of Cardiology, Mustafa Kemal University, Antakya 31100, Turkey; (N.K.); (S.A.); (O.A.); (A.K.)
| | - Nagehan Küçükler
- Department of Cardiology, Mustafa Kemal University, Antakya 31100, Turkey; (N.K.); (S.A.); (O.A.); (A.K.)
| | - Serbay Arslan
- Department of Cardiology, Mustafa Kemal University, Antakya 31100, Turkey; (N.K.); (S.A.); (O.A.); (A.K.)
| | - Oguz Akkuş
- Department of Cardiology, Mustafa Kemal University, Antakya 31100, Turkey; (N.K.); (S.A.); (O.A.); (A.K.)
| | - Alparslan Kurtul
- Department of Cardiology, Mustafa Kemal University, Antakya 31100, Turkey; (N.K.); (S.A.); (O.A.); (A.K.)
| | - Maria Roselle Abraham
- Cardiology UCSF Health, Department of Medicine, University of California at San Francisco, San Francisco, CA 94143, USA; (H.Y.); (M.R.A.)
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Cianciulli TF, Saccheri MC, Papantoniou A, Méndez RJ, Gagliardi JA, Prado NG, Riarte AR, Morita LA, Clérici JE, Lax JA. Use of tissue doppler imaging for the early detection of myocardial dysfunction in patients with the indeterminate form of Chagas disease. Rev Soc Bras Med Trop 2020; 53:e20190457. [PMID: 32130325 PMCID: PMC7094037 DOI: 10.1590/0037-8682-0457-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/20/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION: Chagas disease is one of the most common diseases in Latin America and heart
involvement is the main cause of death. This study aimed to determine
differences in tissue Doppler imaging (TDI) parameters in the assessment
left and right ventricular function in patients with the indeterminate form
of Chagas disease compared to those in healthy controls. METHODS: We compared 194 patients with the indeterminate form of Chagas disease to 72
age-matched healthy individuals. We considered p-values <0.05 to be
statistically significant. RESULTS: TDI analysis of the right ventricular (RV) showed lengthened isovolumic
relaxation time (IRT) and higher RV index of myocardial performance (RIMP)
and left ventricle (LV) index of myocardial performance (LIMP) in the Chagas
group than in the control group, indicating RV and LV systolic and diastolic
myocardial damage. TDI analysis of the myocardial velocities of the
interventricular septum and the lateral wall of the LV also showed a
systolic and diastolic myocardial damage. CONCLUSIONS: The study results demonstrated early LV systolic and diastolic myocardial
damage in the RV and LV in patients with the indeterminate form of Chagas
disease by TDI. These early findings of RV and LV dysfunction may help
identify patients who will progress to heart failure during the disease
course. TDI should be included in initial patient evaluations because it
allows adequate follow-up and treatment.
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Affiliation(s)
- Tomás Francisco Cianciulli
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina.,Researchers of the Ministry of Health of the Government of the City of Buenos Aires, Argentina
| | - María Cristina Saccheri
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina
| | - Alonso Papantoniou
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina
| | - Ricardo José Méndez
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina
| | - Juan Alberto Gagliardi
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina.,Researchers of the Ministry of Health of the Government of the City of Buenos Aires, Argentina
| | - Nilda Graciela Prado
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina.,Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" , Buenos Aires, Argentina
| | - Adelina Rosa Riarte
- Instituto Nacional de Parasitología "Dr. Mario Fatala Chaben" , Buenos Aires, Argentina
| | - Luis Alberto Morita
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina
| | - Javier Eduardo Clérici
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina
| | - Jorge Alberto Lax
- Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires "Dr. Cosme Argerich", Argentina
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Voigt C, Münch J, Avanesov M, Suling A, Witzel K, Lund G, Patten M. Early segmental relaxation abnormalities in hypertrophic cardiomyopathy for differential diagnostic of patients with left ventricular hypertrophy. Clin Cardiol 2017; 40:1026-1032. [PMID: 28741295 DOI: 10.1002/clc.22761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/19/2017] [Accepted: 06/22/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hypertrophic cardiomyopathy (HCM) is characterized by asymmetric left ventricular hypertrophy (LVH). However, clinical signs can be subtle and differentiation from other causes of LVH is challenging. HYPOTHESIS As diastolic dysfunction (DD) is an early sign in HCM, we aimed to find regional changes in relaxation pattern for differentiation from other entities of LVH. METHODS In 148 patients (81 HCM, 55 arterial hypertension (AHT), 12 Fabry disease) and 63 healthy controls, relaxation patterns were assessed using regional tissue Doppler imaging. In 42 HCM patients, myocardial mass and fibrosis were quantified by cardiac magnetic resonance imaging and correlated with relaxation parameters. RESULTS In HCM the septal to lateral isovolumic relaxation time (s/l IVRT) ratio was higher (1.5 ± 0.4) compared with AHT (1.1 ± 0.2), Fabry disease (1.0 ± 0.1), and controls (1.1 ± 0.2; P < 0.001), showing 77% sensitivity and 79% specificity to discriminate HCM-related LVH from other entities. The s/l IVRT ratio was independent of global DD in HCM (HCM with DD: 1.5 ± 0.5, n = 52; HCM without DD: 1.5 ± 0.3, n = 29) and remained significantly different from other entities in a subgroup of HCM patients with maximum wall thickness < 20 mm (s/l ratio: 1.5 ± 0.5, n = 28). Regional IVRT did not correlate with the corresponding segmental myocardial mass or amount of fibrosis in cardiac magnetic resonance imaging. CONCLUSIONS HCM patients show a prolonged septal IVRT irrespective of the extent of LVH and even before developing global DD. The s/l IVRT ratio is significantly higher in HCM compared with AHT or Fabry disease, thus establishing segmental IVRT analysis as a potential parameter for differential diagnosis in LVH.
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Affiliation(s)
- Christian Voigt
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Germany
| | - Julia Münch
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Germany
| | - Maxim Avanesov
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Anna Suling
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Katrin Witzel
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Germany
| | - Gunnar Lund
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Monica Patten
- Department of General and Interventional Cardiology, University Heart Center Hamburg, Germany
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4
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Silva D, Madeira H, Almeida A, Brito D. Tissue Doppler imaging and plasma N-terminal probrain natriuretic peptide for the identification of hypertrophic cardiomyopathy mutation carriers. Am J Cardiol 2013; 112:996-1004. [PMID: 23831167 DOI: 10.1016/j.amjcard.2013.05.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 05/08/2013] [Accepted: 05/08/2013] [Indexed: 11/17/2022]
Abstract
Previous studies have shown that tissue Doppler imaging (TDI) is able to identify mutation carriers of hypertrophic cardiomyopathy (HC) before the development of the clinical phenotype. However, data are scarce and have sometimes been controversial. We performed a systematic study that included conventional echocardiography, TDI, and plasma NT-probrain natriuretic peptide (NT-proBNP) measurement to evaluate the parameters that could identify HC mutation carriers. A total of 138 genotyped subjects were included and divided into 3 groups: group 1, those with HC (n = 62); group 2, mutation carriers (first-degree relatives with a positive genotype but negative phenotype; n = 34); and group 3, controls (first-degree relatives with a negative genotype and phenotype; n = 42). An echocardiographic study, including TDI, was performed on all subjects, and a TDI-derived index (global function index) was also determined. The age-adjusted mean differences in the echocardiographic and TDI parameters and NT-proBNP levels were compared among the 3 groups. Compared with the HC group, the carriers had significantly higher mean E' velocities, lower mean E/E' ratio, higher mean S' velocities, and lower mean global function index and NT-proBNP values. The carriers and controls did not differ significantly either in the echocardiographic parameters studied or in the NT-proBNP levels. In conclusion, the echocardiographic and TDI parameters and NT-proBNP levels cannot be used to identify the HC mutation carrier state and therefore do not appear to be reliable for the purpose of making a preclinical diagnosis of the disease.
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Affiliation(s)
- Doroteia Silva
- Cardiology Department, Santa Maria University Hospital, Lisbon, Portugal.
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5
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Eshoo S, Semsarian C, Ross DL, Marwick TH, Thomas L. Comparison of left atrial phasic function in hypertrophic cardiomyopathy versus systemic hypertension using strain rate imaging. Am J Cardiol 2011; 107:290-6. [PMID: 21129716 DOI: 10.1016/j.amjcard.2010.08.071] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 08/31/2010] [Accepted: 08/31/2010] [Indexed: 11/27/2022]
Abstract
The aim of this study was to determine if left atrial (LA) phasic function evaluated by Doppler tissue imaging-derived strain and strain rate would be differentially decreased in patients with hypertrophic cardiomyopathy (HC) compared to patients with hypertension and to normal controls. Thirty-seven patients with HC were compared to 44 patients with systemic hypertension (SH) and 65 normal controls using transthoracic echocardiography. Maximal and minimal LA volume and LA volume just before active atrial contraction (pre-P LA volume) were measured, and phasic LA volumes were calculated. Global and segmental systolic strain rate, early diastolic strain rate, and late diastolic strain rate (A-Sr) and strain were measured from Doppler tissue imaging. Left ventricular mass was increased in the HC and SH groups compared to normal controls, but diastolic dysfunction was greater in the HC group. LA volumes were increased in patients with HC compared to those with SH and to normal controls, with corresponding reductions in A-Sr and atrial strain in the HC group. In contrast, only early diastolic strain rate was decreased in the SH group compared to controls. A-Sr remained reduced in patients with HC compared to the SH group, even after adjusting for left ventricular mass. When left ventricular mass, parameters of diastolic function (peak E and E' velocity), and the effect of patient group (SH vs HC) were examined in a stepwise regression model, patient group (SH vs HC) was the only independent determinant of A-Sr. In conclusion, HC results in LA enlargement with reduced LA phasic function that is reflected in reductions in A-Sr and atrial strain. Atrial enlargement is a likely consequence of the greater diastolic dysfunction in the HC group.
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Yalçin F, Yalçin H, Küçükler N, Abraham TP. Quantitative left ventricular contractility analysis under stress: a new practical approach in follow-up of hypertensive patients. J Hum Hypertens 2010; 25:578-84. [DOI: 10.1038/jhh.2010.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- F Yalçin
- Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, Cardiovascular Imaging Center, Baltimore, MD 21205, USA.
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7
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Butz T, van Buuren F, Mellwig KP, Langer C, Plehn G, Meissner A, Trappe HJ, Horstkotte D, Faber L. Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: a study in athletes and in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 2010; 27:91-100. [DOI: 10.1007/s10554-010-9665-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 06/28/2010] [Indexed: 10/19/2022]
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8
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Left Atrial Phasic Volumes Are Modulated by the Type Rather Than the Extent of Left Ventricular Hypertrophy. J Am Soc Echocardiogr 2010; 23:538-44. [DOI: 10.1016/j.echo.2010.01.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Indexed: 11/21/2022]
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9
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Chejtman D, Baratta S, Fernández H, Ferroni F, Bilbao J, Kotliar C, Marani A, Turri D, Hita A. Clinical Value of the Tissue DopplerSWave to Characterize Left Ventricular Hypertrophy as Defined by Echocardiography. Echocardiography 2010; 27:370-7. [DOI: 10.1111/j.1540-8175.2009.01044.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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10
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Saccheri MC, Cianciulli TF, Lax JA, Guerra JE, Redruello HJ, Weich Glogier FL, Gagliardi JA, Dorelle AN, Prezioso HA, Vidal LA. Impaired myocardial function in hypertrophic cardiomyopathy. Echocardiography 2009; 26:657-64. [PMID: 19594814 DOI: 10.1111/j.1540-8175.2008.00871.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Tissue Doppler imaging (TDI) parameters of peak myocardial velocities (S', E', and A') has been employed to assess the regional left ventricular myocardial function. The global function index (GFI) derived from TDI has been recently employed to distinguish the different etiologies of left ventricular hypertrophy. OBJECTIVE To analyze whether the GFI or individual TDI parameters of peak myocardial velocities (S', E', and A') allows detecting different degrees of regional myocardial dysfunction in the most frequent forms of hypertrophic cardiomyopathy (HCM). METHODS GFI = (E/E')/S' (where E is the peak transmitral flow velocity, E' is the early diastolic myocardial velocity, and S' is the peak systolic myocardial velocity) and TDI peak myocardial velocities was measured in the septal and lateral mitral annulus in 101 patients with HCM (mean age 47.5 +/- 14 years, 58 women) and in age-matched group of 30 healthy controls (mean age 46 +/- 6 years, 16 women). RESULTS Forty-five patients had nonobstructive asymmetric septal HCM, 20 patients had a subaortic gradient >or= 30 mm Hg, 21 p. had apical HCM, and 15 p. had other forms of HCM (midventricular, symmetric, and biventricular). All patients with HCM exhibited a decrease in early diastolic (E') and systolic (S') myocardial velocities, both in the lateral and septal-mitral annulus border, but more pronounced in septal-mitral annulus. Septal GFI was higher in HCM patients than in healthy subjects (1.8 (1.1-2.5) and (0.57 (0.31-0.92), respectively, P < 0.001), but no differences were seen when different forms of HCM were compared. CONCLUSIONS In a selected population of patients with HCM and a preserved left ventricular(LV) systolic function, GFI and individual TDI parameters of peak velocity (S', E', and A') and E/E' ratio were similar in different forms of HCM, indicating that in all patients with HCM there is regional systolic and diastolic myocardial dysfunction, regardless of the location of hypertrophy.
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Affiliation(s)
- María C Saccheri
- Division of Cardiology, Hospital of the Government of the City of Buenos Aires Dr. Cosme Argerich, Buenos Aires, Argentina.
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11
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Ghio S, Revera M, Mori F, Klersy C, Raisaro A, Raineri C, Serio A, Pasotti M, Visconti LO. Regional abnormalities of myocardial deformation in patients with hypertrophic cardiomyopathy: correlations with delayed enhancement in cardiac magnetic resonance. Eur J Heart Fail 2009; 11:952-7. [PMID: 19789398 DOI: 10.1093/eurjhf/hfp122] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Stefano Ghio
- Division of Cardiology; Fondazione IRCCS Policlinico S. Matteo; Piazza Golgi 1 Pavia 27100 Italy
| | - Miriam Revera
- Division of Cardiology; Fondazione IRCCS Policlinico S. Matteo; Piazza Golgi 1 Pavia 27100 Italy
| | - Francesca Mori
- Division of Cardiology; Fondazione IRCCS Policlinico S. Matteo; Piazza Golgi 1 Pavia 27100 Italy
| | - Catherine Klersy
- Clinical Epidemiology and Biometry Service; Fondazione IRCCS Policlinico S. Matteo; Pavia Italy
| | - Arturo Raisaro
- Division of Cardiology; Fondazione IRCCS Policlinico S. Matteo; Piazza Golgi 1 Pavia 27100 Italy
| | - Claudia Raineri
- Division of Cardiology; Fondazione IRCCS Policlinico S. Matteo; Piazza Golgi 1 Pavia 27100 Italy
| | - Alessandra Serio
- Centre for Inherited Cardiovascular Diseases; Fondazione IRCCS Policlinico S. Matteo; Pavia Italy
| | - Michele Pasotti
- Centre for Inherited Cardiovascular Diseases; Fondazione IRCCS Policlinico S. Matteo; Pavia Italy
| | - Luigi Oltrona Visconti
- Division of Cardiology; Fondazione IRCCS Policlinico S. Matteo; Piazza Golgi 1 Pavia 27100 Italy
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El-Menyar AA, Galzerano D, Asaad N, Al-Mulla A, Arafa SEO, Al Suwaidi J. Detection of myocardial dysfunction in the presence of normal ejection fraction. J Cardiovasc Med (Hagerstown) 2007; 8:923-33. [PMID: 17906478 DOI: 10.2459/jcm.0b013e328014daf2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Detection of subclinical myocardial involvement is of utmost importance in risk stratification and prognosis; the role of ejection fraction in the detection of subclinical disease may be unhelpful. Our aim was to evaluate the methodology and importance of early detection of myocardial involvement in the presence of normal ejection fraction. Most of the pertinent English and non-English articles published from 1980 to 2006 in Medline, Scopus, and EBSCO Host research databases have been reviewed. Serial assessment of systolic function with different techniques should be avoided, since imaging modalities and ejection fraction measurements are not interchangeable. Additional non-invasive tools still are needed for the identification of subclinical left ventricular dysfunction in certain diseases. The recognition of subclinical involvement will prompt initiation of specific therapy to prevent the development of overt left ventricular dysfunction. This also is needed for determining the best timing for intervention in asymptomatic patients with metabolic and valvular disorders.
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Affiliation(s)
- Ayman A El-Menyar
- Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar.
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Araujo AQ, Arteaga E, Ianni BM, Fernandes F, Ramires FJ, Buck PC, Salemi VMC, Nastari L, Mady C. Relationship between outflow obstruction and left ventricular functional impairment in hypertrophic cardiomyopathy: a Doppler echocardiographic study. Echocardiography 2007; 23:734-40. [PMID: 16999691 DOI: 10.1111/j.1540-8175.2006.00303.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Left ventricular outflow tract (LVOT) obstruction is predictive of a worse outcome in hypertrophic cardiomyopathy (HCM). In a detailed Doppler echocardiographic study of 178 selected HCM patients, the group of patients (n = 73) with the obstructive form (resting peak gradient > or = 30 mmHg) presented more hypertrophy and poorer systolic and diastolic left ventricular (LV) functions than the HCM group (n = 105) without obstruction. LVOT peak gradient was positively correlated with hypertrophy (P < 0.0001) and negatively to tissue Doppler mitral annulus systolic (P = 0.0001) and early diastolic (P < 0.0001) velocities. The gradient significantly correlated with E/Ea ratio (r = 0.67; P < 0.0001). By multiple regression, LVOT gradient was related to E/Ea, LV maximal thickness and left atrial size. In comparison with patients without obstruction, patients with obstruction presented greater hypertrophy (P < 0.0001), lower systolic and early diastolic mitral annulus velocities (both P < 0.0001), higher E/Ea ratio (P < 0.0001) and higher global function index (P < 0.0001). In HCM, beyond the effects on hypertrophy, LVOT obstruction is an independent determinant of LV functional abnormalities.
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Affiliation(s)
- Aloir Q Araujo
- Cardiomyopathies Division-Heart Institute (InCor), University of São Paulo Medical School, Av. Eneas Carvalho Aguiar 44, 05403-900 São Paulo, SP, Brazil.
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14
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New Aspects of Septal Function by Using 1-Dimensional Strain and Strain Rate Imaging. J Am Soc Echocardiogr 2006; 19:1345-9. [DOI: 10.1016/j.echo.2006.05.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Indexed: 12/14/2022]
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15
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Sampedrano CC, Chetboul V, Gouni V, Nicolle AP, Pouchelon JL, Tissier R. Systolic and Diastolic Myocardial Dysfunction in Cats with Hypertrophic Cardiomyopathy or Systemic Hypertension. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb00708.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Fowler SJ, Narula J, Gurudevan SV. Review of Noninvasive Imaging for Hypertrophic Cardiac Syndromes and Restrictive Physiology. Heart Fail Clin 2006; 2:215-30. [PMID: 17386891 DOI: 10.1016/j.hfc.2006.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Araujo AQ, Arteaga E, Ianni BM, Salemi VMC, Ramires FJA, Matsumoto AY, Fernandes F, Mady C. Usefulness of a New Proposed Tissue Doppler Imaging Global Function Index in Hypertrophic Cardiomyopathy. Echocardiography 2006; 23:197-201. [PMID: 16524389 DOI: 10.1111/j.1540-8175.2006.00198.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND A global function index (GFI) derived from tissue Doppler imaging (TDI) has been proposed to improve the diagnosis of hypertrophic cardiomyopathy (HCM). We aimed to evaluate the usefulness of this index in a large selected HCM population. METHODS GFI =[E/Ea]/Sa, was calculated at mitral annulus lateral and septal borders in 164 HCM patients and in 40 healthy volunteers. Group comparisons and correlations between GFI and other variables were performed. RESULTS Of the 164 patients, 69 (42%) had a peak gradient >30 mmHg in the left ventricle outflow tract (LVOT). GFI (lateral or septal) was not normally distributed. There were differences among controls, obstructive HCM, and nonobstructive HCM (P < 0.0001), but significant overlap of GFI values were observed between groups. GFI was correlated to septal thickness (r = 0.44; P < 0.0001), left atrial diameter (r = 0.52; P < 0.0001), and LVOT gradient (r = 0.58; P < 0.0001). CONCLUSION In a selected HCM population, GFI was limited by its asymmetrical distribution and significant overlap of values between groups. Further studies are necessary to verify the reliability of GFI in the clinical practice and its position among other tissue Doppler indices.
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Affiliation(s)
- Aloir Q Araujo
- Heart Institute (INCOR), University of São Paulo Medical School, São Paulo, Brazil.
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18
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Saccheri MC, Cianciulli TF, Konopka IV, Guerra JE, Acunzo RS, Serans DF, Lax JA, Prezioso HA, Vidal LA, Elizari MV. Utilidad del Doppler pulsado tisular en la detección precoz de anormalidades diastólicas en familiares de primer grado de pacientes con miocardiopatía hipertrófica familiar. Rev Esp Cardiol 2006. [DOI: 10.1157/13083648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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