| ǥ :
|
ȣ - 480550 156 |
| Comparison of Myocardial Tissue Doppler with Color M-mode Flow Propagation Velocities in Hypertensive Left Ventricular Hypertrophy |
| Division of Cardiology, Department of internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea |
| Sung-Ji Park, Jeong-Rang Park, Su-nyoung Choi, Tae-Jung Kwon, So-La Park, Young-Ran Kang, Chung-Whan Gak, Jin-Young Hwang |
Introduction Abnormalities of left ventricular (LV) relaxation and diastolic filling have been reported in patients with hypertension (HTN) by mitral inflow pulsed wave Doppler velocities. Doppler tissue imaging (DTI) and color M-mode flow propagation (FP) velocities are useful for assessment of LV diastolic function regardless of loading conditions. The purpose of this study was to compare DTI and FP for the assessment of abnormal relaxation in patients with HTN. Methods Conventional 2D echocardiography with Doppler was performed in 200 subjects: HTN (n=100, age 66±17 years, 46 males) and normal controls (NC, n=100, 50±12 years, 46 males). 2D echo measurements included: LV ejection fraction (EF), LV mass index (LVMI); mitral inflow pulsed wave Doppler indices included E/A wave ratio, deceleration time and isovolumic relaxation time intervals. Tissue Doppler early diastolic myocardial (Em) velocity was recorded at the septal annulus; color M-mode flow propagation (FP) velocity was obtained in the apical 4 chamber view. Subjects with HTN were divided into two groups: left ventricular hypertrophy (LVH: LVMI≥134 g/m2 in men, ≥110 g/m2 in women) and non-LVH (NLVH). Results Among patients with HTN, 65 met criteria for LVH (HTN+LVH). Although the NC group was significantly younger than the HTN+LVH group, there was no age difference between HTN+LVH and HTN+NLVH (n=35) groups. By design, the HTN+LVH group had significantly higher LVMI compared to both HTN+NLVH and NC groups, although the LVEF was similar across all three groups (HTN+LVH: LVMI 165.3±32 g/m2,EF 65±13%; HTN+NLVH LVMI 115±22.2 g/m2,EF 62.9±13.9%; NC: LVMI 113±17 g/m2, EF 66± 8%). Although all Doppler variables except FP allowed discrimination between HTN+LVH and NC groups, only TDI Em at the septal bases was significantly different both between HTN+LVH and HTN+NLVH groups and between HTN+NLVH and NC groups. There were no statistically significant differences in color M-mode FP velocities across any of the groups. Conclusions In the presence of LVH and preserved left ventricular systolic function, TDI Em velocities are more sensitive than color M-mode FP velocities in detecting abnormal left ventricular relaxation.
|
|
|
|
|
