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01-03-2011 | Original Investigation

Heterogeneity of apex-to-base dispersion in diastolic lengthening is related to impaired global left ventricular relaxation in patients with hypertrophic cardiomyopathy

Authors: Takeo Tanaka, Kazuya Murata, Eizo Akagawa, Yasuaki Wada, Shinichi Okuda, Takehisa Susa, Yoshio Nose, Hiroko Yoshino, Chikage Kihara, Masunori Matsuzaki

Published in: Journal of Echocardiography | Issue 1/2011

Abstract

Background

The presence of apex-to-base disparity in diastolic left ventricle (LV) endocardial lengthening, based on an electromechanical activation sequence, has been recognized as an important determinant of LV diastolic properties. However, the behavior of LV apical and basal diastolic lengthening and its relationship to LV filling in hypertrophic cardiomyopathy (HCM) are unknown.

Methods

We obtained basal and apical LV short-axis views in 27 patients with non-obstructive HCM and 25 healthy volunteers. The patients with HCM were subdivided into two groups; those with apical hypertrophy [APH(+)] or those without apical hypertrophy [APH(−)]. Eight equiangular points on the endo-myocardium at end diastole were placed in each view, and the movements of these points were automatically tracked using a two-dimensional echocardiographic tissue tracking system. Time–LV internal diameter curves were obtained and averaged. The time intervals from the aortic valve closure to the point of the first 40% of peak diastolic lengthening (T ₄₀) were measured in each view. The standard deviation of the time to peak systolic circumferential shortening at the base and apex were calculated to assess the heterogeneity of LV contraction.

Results

The time difference in the T ₄₀ between the apex and base (dt-T ₄₀) in the HCM-APH(+) and HCM-APH(−) groups was greater than that in the control group. The heterogeneities in LV apical systolic shortening in the HCM groups were greater than those in the control group. There were good linear correlations between the dt-T ₄₀ and the LV early diastolic echo-parameters and the LV mass index.

Conclusions

Delayed apical relaxation and filling in patients with HCM is related to LV diastolic dysfunction and systolic dyssynchronous contraction.

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Title: Heterogeneity of apex-to-base dispersion in diastolic lengthening is related to impaired global left ventricular relaxation in patients with hypertrophic cardiomyopathy
Authors: Takeo Tanaka
Kazuya Murata
Eizo Akagawa
Yasuaki Wada
Shinichi Okuda
Takehisa Susa
Yoshio Nose
Hiroko Yoshino
Chikage Kihara
Masunori Matsuzaki
Publication date: 01-03-2011
Publisher: Springer Japan
Published in: Journal of Echocardiography / Issue 1/2011
Print ISSN: 1349-0222
Electronic ISSN: 1880-344X
DOI: https://doi.org/10.1007/s12574-010-0059-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Heterogeneity of apex-to-base dispersion in diastolic lengthening is related to impaired global left ventricular relaxation in patients with hypertrophic cardiomyopathy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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