Document Detail


Delayed left ventricular untwisting in hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  19815387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Almost all patients with hypertrophic cardiomyopathy (HCM) have some degree of left ventricular (LV) diastolic dysfunction. Nevertheless, the pathophysiology remains incompletely characterized. Conceptually, an ideal therapeutic agent should target the underlying mechanisms that cause LV diastolic dysfunction. Assessment of diastolic LV untwisting could potentially be helpful to gain insight into the mechanism of diastolic dysfunction. The purpose of this study was to investigate LV untwisting in patients with HCM and control subjects. METHODS: LV untwisting parameters were assessed using speckle-tracking echocardiography in 75 consecutive patients with HCM and compared with those from 75 healthy control subjects. RESULTS: Untwisting at 5%, 10%, and 15% of diastole was lower in patients with HCM (all P values < .001) compared with control subjects. Peak diastolic untwisting velocity (-92 +/- 32 degrees/s vs -104 +/- 39 degrees/s, P < .05) and untwisting rate from peak systolic twist to mitral valve opening (MVO) (-37 +/- 20 degrees/s vs -46 +/- 22 degrees/s, P < .01) were lower, while the for diastolic duration normalized time-to-peak diastolic untwisting velocity (17 +/- 9% vs 13 +/- 9%, P < .05) was higher in patients with HCM. Untwisting rate from peak systolic twist to MVO was negatively correlated with the E/A ratio (R(2) = 0.15, P < .01). Peak diastolic untwisting velocity and untwisting rate from peak systolic twist to MVO were increased in mild but decreased in moderate and severe diastolic dysfunction compared with control subjects. CONCLUSION: LV untwisting is delayed in HCM, which probably significantly contributes to diastolic dysfunction.
Authors:
Bas M van Dalen; Floris Kauer; Michelle Michels; Osama I I Soliman; Wim B Vletter; Heleen B van der Zwaan; Folkert J ten Cate; Marcel L Geleijnse
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Publication Detail:
Type:  Journal Article     Date:  2009-10-07
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  22     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-30     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1320-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Hypertrophic / complications*,  ultrasonography*
Echocardiography / methods*
Female
Heart Ventricles / ultrasonography*
Humans
Male
Reproducibility of Results
Sensitivity and Specificity
Ventricular Dysfunction, Left / complications*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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