Characteristics of the Doppler Myocardial Imaging in Patients with Myocardial Hypertrophy

Hyun, Dae Woo; Kim, Kee Sik; Kwon, Sang Min; Kim, Min Jung; Park, Chang Wook; Lee, Young Soo; Han, Seong Wook; Hur, Seung Ho; Kim, Yoon Nyun; Kim, Kwon Bae

Abstract

BACKGROUND
Myocardial Doppler imaging has allowed the quantification of regional myocardial motion. The aim of this study was to characterize regional left ventricular systolic and diastolic function by myocardial Doppler imaging (velocity and deformation) in patients with normal, concentric hypertrophy due to hypertension and hypertrophic cardiomyopathy (HCM). METHOD: In forty-five patients (normal 15, concentric hypertrophy 15, HCM 15), we assessed the time velocity integral (systolic, early and late diastolic), systolic strain and strain rate (SR) (systolic, early and late diastolic) at apical 4 chamber view (basal septum, mid-septum, apical setum, apex, apico-lateral, mid-lateral, and basal lateral wall). RESULT: The mean interventricular septal dimensions of normal, concentric hypertrophy and HCM were 0.96 cm, 1.31 cm and 1.73 cm, respectively (p<001). Patients with HCM reduced peak systolic strain, systolic SR, early diastolic SR and late diastolic SR at mid-septum (-0.58%, -0.92/sec, 0.37/sec, 1.06/sec, respectively) compared with that in normal and concentric hypertrophy (-20.27%, -1.71/sec, 1.58/sec, 1.94/sec, p<0.01and -14.37%, -1.01/sec, 1.31/sec, 1.73/ sec, p<0.01). In the patients with HCM, peak systolic strain in mid-septum (-0.58%) was significantly less than that in the basal, and apical septum and apical, mid, and basal lateral wall (-14.21%, -18.47%, -8.81%, -9.00%, -8.58%, respectively, p<0.05). In the concentric hypertrophy group, the average peak systolic strain of septal and lateral wall (-16.88%, -5.82%) were reduced compared with that in normal group (-2119%, -14.40%, respectively, p<0.05). The interventricular septal dimension was significant correlation between mid-septal systolic strain, systolic SR, early diastolic SR, and late diastolic SR (r=0.707 p<0.01, r=0689 p< 0.01, r=-0.687 p<0.01, r=-0.554 p<0.01) in all 45 patients.
CONCLUSION
Hypertrophied myocardium had abnormality of myocardium deformation related to the degree of hypertrophy. Myocardial Doppler imaging offer a approach to quantify regional systolic and diastolic dysfunction.