| Use of tissue Doppler to distinguish discrete upper ventricular septal hypertrophy from obstructive hypertrophic cardiomyopathy. | |
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MedLine Citation:
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PMID: 18471465 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Discrete upper septal hypertrophy (DUSH) is a well-recognized but poorly understood echocardiographic finding that may indicate localized remodeling modulated by pressure loading or a forme fruste variant of obstructive hypertrophic cardiomyopathy (HC). It was hypothesized that (1) a comparison of tissue Doppler indexes of myocardial function in normal patients and those with DUSH or aortic stenosis (AS) could provide insight into the clinical significance of DUSH and (2) these indexes could distinguish between DUSH and obstructive HC. A retrospective analysis was performed on patients aged 50 to 80 years who underwent routine echocardiography and who could be classified into normal, DUSH, AS, and HC groups (n = 25, 33, 23, and 34, respectively) on the basis of clinical and echocardiographic criteria. Early diastolic mitral annular velocities (Ea) in the DUSH (7.1 +/- 1.8 cm/s) and AS (7.1 +/- 1.7 cm/s) groups were lower compared with those in the normal group (9.3 +/- 1.9 cm/s) and higher compared with those in the HC group (5.4 +/- 1.3 cm/s), whereas the E/Ea ratio was higher in the DUSH and AS groups (10.0 +/- 3.1 and 11.3 +/- 2.8, respectively) compared with the normal group (7.1 +/- 1.6) and lower compared with the HC group (18.8 +/- 7.5). These differences remained significant after adjusting for age and the use of beta blockers and calcium channel blockers. E/Ea > or =13 distinguished between patients with HC and those with DUSH (sensitivity 78%, specificity 90%, positive predictive value 90%, negative predictive value 81%). In conclusion, abnormal Ea and E/Ea in patients with DUSH, with values similar to those in patients with AS, suggest that DUSH may represent a variant hypertrophic response to chronic pressure loading. Simple echocardiographic indexes may be helpful in distinguishing between patients with DUSH and those with obstructive HC. |
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Authors:
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Annabel Chen-Tournoux; Michael A Fifer; Michael H Picard; Judy Hung |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-03-17 |
Journal Detail:
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Title: The American journal of cardiology Volume: 101 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-12 Completed Date: 2008-06-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1498-503 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Cardiomyopathy, Hypertrophic / physiopathology, ultrasonography* Diagnosis, Differential Echocardiography, Doppler / methods* Female Follow-Up Studies Humans Hypertrophy, Left Ventricular / physiopathology, ultrasonography* Hypertrophy, Right Ventricular / physiopathology, ultrasonography* Male Middle Aged Prognosis Retrospective Studies Stroke Volume / physiology Ventricular Function / physiology* Ventricular Septum / ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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