Assessment Of Ventricular Electromechanical Synchrony In Patients With Hypertrophic Cardiomyopathy By Doppler Tissue Imaging

Objective:To assess ventricular electromechanical synchrony in patients with hypertrophic cardiomyopathy by Doppler tissue imaging technique.Methods:The study population included 38 HCM patients (38.5±6.9 years) and 38 patients with hypertensive heart disease( HHD) and 38 age- and sex-matched healthy subjects, By use of pulsed DTI, In five different basal myocardial segments: septum, LV inferior wall, LV anterior wall, LV lateral wall (at the level of mitral annulus), and RV lateral wall (at the level of tricuspid annulus). the following regional parameters were evaluated: systolic (Sm) and early -diastolic (Em and Am) peak velocities and Em/Am ratio and precontraction time (Q-Sm) (from the beginning of Q-wave of ECG to the onset of Sm). Change of myocardial intraventricular (intra-V-Del) and interventricular (inter-V-Del) systolic delays was analysed in three groupsResults:DTI analysis in hypertensive heart disease( HHD) patients and in reference subjects HCM showed greater myocardial systolic and early-diastolic peak velocities and Em/Am ratio of all the segments than in HCM subjects( P<0.05) . whereas Sm did not differ significantly between HHD patients and reference subjects( P>0.05). and Em and Em/Am at the level of mitral annulus was smaller in HHD patients than in reference patients( P<0.05) . whereas Em and Em/Am of RV lateral wall at the level of tricuspid annulus did not differ significantly between HHD patients and reference patients( P>0.05).As for time intervals, Q-Sm was smaller in patients with HHD and in reference subjects than in HCM patients( P<0.01) . HCM showed significant inter- and intra-V delays (P< 0.001), whereas homogeneous systolic activation of the ventricular walls was assessed in reference subjects and in patients with HHD. In HCM patients, intra-V-Del was positively associated with septal wall thickness (P <0.001), whereas no significant association was detected between intra-V-Del and septal wall thickness in patients with HHDConclusion:Impairment of systolic synchrony of left ventricular motion and systolic function exists in HCM group. Accordingly, DTI parameters may provide significant prognostic value and clinical information of early intensive treatment in patients with hypertrophic cardiomyopathy by Doppler tissue imaging。...