Document Detail


Tissue Doppler imaging consistently detects myocardial abnormalities in patients with hypertrophic cardiomyopathy and provides a novel means for an early diagnosis before and independently of hypertrophy.
MedLine Citation:
PMID:  11447072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular hypertrophy (LVH), the clinical hallmark of familial hypertrophic cardiomyopathy (FHCM), is absent in a significant number of subjects with causal mutations. In transgenic rabbits that fully recapitulate the FHCM phenotype, reduced myocardial tissue Doppler (TD) velocities accurately identified the mutant rabbits, even in the absence of LVH. We tested whether humans with FHCM also consistently showed reduced myocardial TD velocities, irrespective of LVH.
METHODS AND RESULTS: We performed 2D and Doppler echocardiography and TD imaging in 30 subjects with FHCM, 13 subjects who were positive for various mutations but did not have LVH, and 30 age- and sex-matched controls (all adults; 77% women). LV wall thickness and mass were significantly greater in FHCM subjects (P<0.01 versus those without LVH and controls). There were no significant differences in 2D echocardiographic, mitral, and pulmonary venous flow indices between mutation-positives without LVH and controls. In contrast, systolic and early diastolic TD velocities were significantly lower in both mutation-positives without LVH and in FHCM patients than in controls (P<0.001). Reduced TD velocities had a sensitivity of 100% and a specificity of 93% for identifying mutation-positives without LVH.
CONCLUSIONS: Myocardial contraction and relaxation velocities, detected by TD imaging, are reduced in FHCM, including in those without LVH. Before and independently of LVH, TD imaging is an accurate and sensitive method for identifying subjects who are positive for FHCM mutations.
Authors:
S F Nagueh; L L Bachinski; D Meyer; R Hill; W A Zoghbi; J W Tam; M A Quiñones; R Roberts; A J Marian
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  104     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-11     Completed Date:  2001-08-09     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, TX, USA. sherifn@bcm.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Flow Velocity / genetics
Cardiomyopathy, Hypertrophic / complications,  diagnosis*,  genetics*
Diastole
Echocardiography*
Echocardiography, Doppler*
Female
Genes, Dominant
Genetic Predisposition to Disease
Humans
Hypertrophy, Left Ventricular / diagnosis*,  etiology
Male
Mutation
Predictive Value of Tests
Sensitivity and Specificity
Systole
Ventricular Function, Left / genetics
Grant Support
ID/Acronym/Agency:
P50 HL054313-060012/HL/NHLBI NIH HHS; P50 HL054313-070012/HL/NHLBI NIH HHS; P50 HL054313-080012/HL/NHLBI NIH HHS; P50 HL054313-08S10012/HL/NHLBI NIH HHS; P50 HL054313-090012/HL/NHLBI NIH HHS; P50 HL054313-100012/HL/NHLBI NIH HHS; P50-HL42267-01/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Circulation. 2001 Jul 10;104(2):126-7   [PMID:  11447071 ]

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