Document Detail


Use of tissue Doppler to distinguish discrete upper ventricular septal hypertrophy from obstructive hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  18471465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Annabel Chen-Tournoux; Michael A Fifer; Michael H Picard; Judy Hung
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-03-17
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-12     Completed Date:  2008-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1498-503     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
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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