Effects Of Left Ventricular Hypertrophy On Synchrony Of Left Ventricular Motion And Function With Myocardial Tissue Doppler Imaging

Objective This study measured the time dispersity of electromechanical motion of left artrial-ventricular annulus and velocity parameters of left ventricular(LV) myocardium various segments with Tissue Doppler Imaging(TDI) to assess the effects of synchrony of left ventricular hypertrophy(LVH) on LV motion and function.Methods 18 patients with hypertensive heart disease(HHD) and 16 patients with hypertrophic cardiomyopathy(HCM) and 18 age-matched healthy subjects as control group were included. The examinations were performed with patients at rest in the left lateral supine position or supine position, With the guidance of apical four-chamber view of two-demensional echocardiography, Mitral vavle flow spectrum were measured by pulsed Doppler ultrasound. Then on the base of the apical four-chamber view of two-demensional echocardiography, pulsed TDI was performed to record the LV septum, lateral, anterior, inferior motion pattern in the artrial-ventricular annulus. The time dispersity of electromechanical motion at LV systole and diastole were measured, Peak systolic velocity(Vs), peak early diastolic velocity(Ve), peak late diastolic velocity(Va) were measured in left ventricular septum, lateral on artrial-ventricular annulus,1/4 point, 1/2 point.Results(1) Left ventricular motion:Time dispersity of electromechanical motion in systole increased in HHD and HCM patients, but compared with those of healthy individuals, there was significant difference in HCM patients(28.17±15.15ms vs 15.6±3.5ms p<0.05); Time dispersity of electromechanical motion in diastole significant increased in all patients compared with those of healthy individuals(HHD 36.43±9.30ms vs 24.30±6.22ms p<0.05;HCM 56.41±15.93ms vs 24.30±6.22ms p<0.05).(2) Left ventricular systolic function: There was no significant difference in Vs of LVsegments between HHD patients and healthy subjects(p>0.05), however, Vs of LV segments in HCM patients significant increased(p<0.05).(3) Left ventricular diastolic function: Ve of LV segments in HHD and HCM patients were lower than that of healthy subjects(p<0.05); Ve of LV septum, lateral on 1/4 point, 1/2 point in HCM patients were significant lower than that of HHD patients(p<0.05), Morever, Ve of 1/4 point, 1/2 point of LV septum were lower than that of lateral in HCM patients(p<0.05).Conclusions(1) Because of different types and magnitudes of LVH, LV function was significant impaired and LV motion asynchrony in systole and diastole existed in HCM patients; Impairment of LV function and synchrony existed only in diastole in HHD patients.(2) TDI is sensitive and accurate in assessments of LV synchrony and function, especially in detecting change of regional LV myocardial function.