Heterogeneity of apextobase dispersion in diasto

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

Publish Date: 2010/08/17

Volume: 9, Issue: 1, Pages: 9-16

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Abstract

The presence of apextobase 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 unknownWe obtained basal and apical LV shortaxis views in 27 patients with nonobstructive 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 endomyocardium at end diastole were placed in each view and the movements of these points were automatically tracked using a twodimensional 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 contractionThe time difference in the T 40 between the apex and base dtT 40 in the HCMAPH+ and HCMAPH− 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 dtT 40 and the LV early diastolic echoparameters and the LV mass index

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